Providing comfort: Caring for patients who wish to die in their home country

Article Figures & Data

TABLE 1

Examples of medications to consider for travel comfort care

Indication	Medications	Considerations
Long-acting pain control	Fentanyl patch Methadone Morphine extended-release	Current and predicted pain Prior pain medication use, familiarity, and tolerance Future ability to take oral medications
Breakthrough pain or dyspnea	Morphine sulfate oral solution	Can be used when patient loses ability to purposefully swallow
Terminal fever or pain	Acetaminophen	Pills can be used orally or rectally Low risk of diversion
Nausea and vomiting	Ondansetron Promethazine	Consider if single medications can be used for multiple symptoms
Pain, nausea, cancer-related swelling, or obstruction	Dexamethasone	Multimodal effect Benefits usually maximized over 2 weeks Use cautiously if hyperglycemia is a concern
Terminal agitation, anxiety, seizures, and nausea	Lorazepam Olanzapine Haloperidol	Useful for spectrum of symptoms in terminal phase
Constipation	Bisacodyl Polyethylene glycol	Bisacodyl oral pill can be used rectally when patient loses ability to swallow
Secretions, death rattle	Atropine 1% drops	Coach family on repositioning