Hospice/Palliative Care

This information is to guide family members and homeopathy practitioners in their discussions with a dying person about medication management in hospice or palliative care. Many people want a clear head to be present with and for loved ones, which is often not possible when on strong narcotics. At the same time, maximum pain relief is usually a priority. These guidelines are for professionals and not intended for lay people.

Dosage: Low potencies are preferred due to the person’s weakened state but there may be exceptions.

6C, 12C or 30C
May be given orally by pellet; or in water dropped on lips or skin of wrist

Notes:

When a person is also on narcotics, the symptom picture can be difficult because it may be unclear which symptoms are produced by the narcotic and which are the person’s own physical and mental state.
If a constitutional remedy has been successful in the past and covers the presenting symptoms, it may prove helpful. Dr. H. Roberts cites a case where 5 remedies were possibly indicated. One, similar to her constitutional remedy, was used with great success.

Symptoms	Remedy
Announcement of shift to palliation/hospice For patient and/or caregivers View Remedy	Opium 30C (available in European pharmacies) for shock/speechlessness twice a day, if necessary Arnica montana 30C state of shock twice a day, if necessary Staphysagria 15C Sense of injustice, anger twice a day, if necessary
Psychological support For patient and/or caregivers View Remedy	Ignatia 15C for anguish, lump in throat twice a day, if necessary Gelsemium 15C Anxiety, fear of the future twice a day, if necessary Staphysagria 15C Sense of injustice, anger, annoyance Twice a day, if necessary Aconitum napellus 15C sudden, intense anxiety, fear of death twice a day, if necessary
Fighting death Dread/fear of dying fear being left alone Very restless/agitated/anxious tosses and turns in bed can’t get comfortable wants to get up and walk around Agony before and while dying Burning pain better with heat Sensation death is near Exhausted, weak, debilitated Trembling Thirsty for sips of water thirst not quenched Critical, wants things in order around him Feels it is useless to take medicines Worse: after midnight View Remedy	Arsenicum album Dr. Ramakrishnan says: 30C as long as it helps 200C as long as it helps May move higher if no longer helpful Give every 5-30 min in water (stir between doses) until relief obtained If no relief, reassess and change remedies May repeat if it helped earlier
Anxiety/agitation panic attacks Fear – may predict time of death Physical and mental restlessness Sudden shooting pains Clairvoyance/visions Anguish of mind and body Agony before and while dying Worse: night stuffy room Better: warmth (especially nerve pain) View Remedy	Aconitum napellus Dr. Ramakrishnan says: 30C as long as it helps 200C as long as it helps May move higher if no longer helpful Give every 5-30 min in water (stir between doses) until relief obtained If no relief, reassess and change remedies May repeat if it helped earlier
Labored breathing In need of oxygen Needs a window open or constant fanning Collapsed state Cold breath Cold sweat Abdomen distended with gas View Remedy	Carbo vegetabilis Dr. Kent says to give in water every hour for 6 hours then stop
Think they are dead Delusion preparations are being made for funeral Loquacity Hopeless Dread of death Suspicious Critical Hot Streaming perspiration Can’t tolerate clothing: neck, chest, abdomen Choking/suffocation sensation Inward distress in chest/stomach View Remedy	Lachesis
Intense fever especially afternoon Night sweats Constant burning thirst Red spot on cheek Diarrhea Stool leaks when coughing Constriction in chest Feeling of suffocation Anxiety, fear of death View Remedy	Phosphorus Dr. Kent says to administer once only expect short-lived fever aggravation but expect fever to pass
Violent pain in last hours of dying Agony before and while dying Restless/Agitated Intense, tormented behavior Rattling in chest No power to cough out mucus Similar to Arsenicum but Arsenicum fails View Remedy	Tarentula hispanica Dr. Kent used it in 30C potency
COPD Labored breathing Drowning in own phlegm Asphyxia as if from drowning Weak, passive, relaxed state “Death rattle” unable to cough mucus up View Remedy	Antimonium tartaricum
Bone pains Guilt Cardiovascular remedy Believes they deserve reproach Welcomes death Worse: night cold Better: warmth fresh air View Remedy	Aurum metallicum Dr. Ramakrishnan says: 30C as long as it helps 200C as long as it helps May move higher if no longer helpful Give every 5-30 min in water (stir between doses) until relief obtained If no relief, reassess and change remedies May repeat if it helped earlier
Nausea Burning in stomach Vomiting blackish, coffee-ground material Stomach cancer Bad effects of chemotherapy View Remedy	Cadmium sulphuratum 12C 30C Dr. Ramakrishnan says: one dose every 30 min day and night
Liver cancer metastases View Remedy	Chelidonium Dr. Ramikrishnan says: 200C potency alone or alternated with other remedies
Burning pains of cancer Restless Does not like cool air Better: cold applications View Remedy	Euphorbium Dr. Ramakrishnan says: 30C as long as it helps 200C as long as it helps May move higher if no longer helpful Give every 5-30 min in water (stir between doses) until relief obtained If no relief, reassess and change remedies May repeat if it helped earlier
Sensation of hand around the heart Being squeezed – no room to beat Constrictive pain in heart Fear of death View Remedy	Cactus grandiflora
Septic states Hemorrhage Swelling View Remedy	Crotalus horridus
Spasms Cramping Jerking View Remedy	Cuprum
Congestive Heart Failure View Remedy	Digitalis purpurea
Extreme pain Prostration Obstinate constipation View Remedy	Hydrastis Dr. Ramakrishnan says: 30C as long as it helps 200C as long as it helps May move higher if no longer helpful Give every 5-30 min in water (stir between doses) until relief obtained If no relief, reassess and change remedies May repeat if it helped earlier
Screaming with pain Gasping breath Fear of asphyxation Agony before and while dying Sensation of death View Remedy	Latrodectus mactans
Pain from muscle spasms/cramping radiating pain Neuralgic pain Wants to double over to relieve pain Tired, exhausted Better: pressure warmth View Remedy	Magnesia phosphorica Dr. Ramakrishnan says: 30C in warm water 1 teaspoon every 5 minutes repeat 10 times Repeat, if necessary Potency may be increased if necessary
Shocked states Terror Extreme paleness Coma Insensibility Fluid-caused distension Pressure on abdominal organs, brain, lungs Pain leading to severe depression Worse: heat after sleep Better: cold applications fresh air small bits of food walking about View Remedy	Opium Available in European pharmacies Dr. Ramikrishnan cautions: in higher potency, this may bring a patient out of a “merciful coma” that precedes death
Similar use as Opium but for: Neurological, spinal, head pains Intracranial tumors Tumors growing from nerve cells Thyroid/pituitary gland tumors View Remedy	Plumbum iodatum Dr. Ramakrishnan says: 30C as long as it helps 200C as long as it helps May move higher if no longer helpful Give every 5-30 min in water (stir between doses) until relief obtained If no relief, reassess and change remedies May repeat if it helped earlier
Clinginess Restlessness Respiratory discomfort Symptoms constantly changing View Remedy	Pulsatilla
Restlessness Agony before and while dying Worse: night View Remedy	Rhus toxicodendron
Cold, chilly Incontinent bowels Restless Agony before and while dying View Remedy	Veratrum album
Severe pain in chest View Remedy	Bryonia
Nausea Tongue is not coated View Remedy	Ipecachuana
Nausea Vomiting Tongue coated Nervous Irritable/impatient Low pain tolerance Overly sensitive to noise, light, noise Worse: morning eating Better: after nap evening warm applications May help if Arsenicum is no longer helping Arsenicum may help after a few doses of Nux View Remedy	Nux vomica Dr. Ramakrishnan says: 30C as long as it helps 200C as long as it helps May move higher if no longer helpful Give every 5-30 min in water (stir between doses) until relief obtained If no relief, reassess and change remedies May repeat if it helped earlier
Profound weakness due to loss of fluids View Remedy	Cinchona (China)
Sore, bruised feeling must move from side to side View Remedy	Arnica montana

References

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