Hospice Training Guide

MANAGING SYMPTOMS

Anxiety

Agitation & Restlessness

Anxiety is a concern about an event, person, uncertainty, or feeling of not being able to handle things. Often, the reason for uneasiness is not known. Anxiety is a common experience. Anxiety may include:

Restlessness and agitation can be distressing for both the patient and their loved ones, but understand- ing the causes and effective management strategies can help alleviate discomfort and promote a sense of peace. Symptoms can range from mild restlessness and confusion to more pronounced agitation, including yelling, moaning, or even attempts to get out of bed. Agitation & Restlessness can Stem from a Variety of Factors, Including:

• Fear • Worry

• Rapid Breathing or Heartbeat • Sleeplessness • Nightmares • Confusion

• Tension • Shaking • Sweating • Nerves • Jitters

• Fixation on a Situation or Thing • Spiritual Questions/Concerns

How to Help Relieve Anxiety:

• Physical Discomfort: Pain, difficulty breathing, bowel or bladder issues, and tem- perature fluctuations can all contribute. • Medication Side Effects: Some medications, particularly opioids, can cause rest- lessness or agitation as a side effect. • Metabolic Imbalances: Organ failure and changes in body chemistry can affect brain function, leading to agitation. • Emotional Distress: Fear, anxiety, and spiritual or emotional distress can also play a role. • Sensory Changes: Vision or hearing loss can lead to confusion and agitation. How to Help with Agitation & Restlessness

• Write down thoughts and feelings. This can be shared with someone, or can be kept private. Just writing what comes to mind often helps. • Talk with someone you trust. • Engage in relaxing activities such as deep breath- ing or yoga, or listen to soothing music. • Limit the number of visitors, or how long visitors stay, until the patient feels better and more re- laxed. • Gently rub arms, back, hands or feet. Wash your hands and apply lotion between your palms be- fore gently massaging the patient. • Avoid caffeine and alcoholic beverages.

• Exercise regularly. If possi- ble, a few minutes of walk- ing, stretching, or moving in bed or a chair can help ease anxiety. • Use medications as pre-

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scribed. Your Care Team will give you guidance on safe use of medications. • Your Care Team will be able to offer many other suggestions, like massage, relaxation exercises, or music therapy to help reduce anxiety.

• Identify Underlying Causes: It’s crucial to work with the hospice team to identify and address any reversible causes of agitation. • Create a Calm Environment: Reducing noise and visual stimuli, providing soft lighting, and ensur- ing a comfortable temperature can help. • Provide Reassurance and Support: Speak in a calm, reassuring voice, offer gentle touch, and remind the patient that they are safe and loved.

• Medication Management: Hospice professionals can prescribe medications to manage pain, anxiety, or restlessness. • Positioning and Support: Adjusting positioning, providing pillows for support, and offering relaxa- tion techniques like massage can promote comfort. • Stay Present: Remaining with the patient as much as possible can provide comfort and reassurance.

CALL YOUR CARE TEAM IF: • There are problems with relation ships with family or friends. • There are spiritual concerns. • The symptoms of anxiety are getting worse.

866.466.9734 • FourSeasonsCare.org

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