In contrast to its use for opioid addiction maintenance, methadone must be dosed every 6 hours when employed as an analgesic. Active dying As death approaches, pain diminishes. Such visions often involve travel metaphors and contacts with deceased family members. These final days may be a time of intense personal and spiritual work, and the focus of palliative efforts needs to change. Symptoms that patients will complain of most at this time are dry mouth, anorexia, confusion, and general weakness.
Dry mouth is a symptom that appears to be unrelated to hydration state.
13 Relief is accomplished by moistening the mucosa. Salivart and similar products are available for this purpose. It is unnecessary to give fluids to relieve the symptom of dry mouth, beyond what the patient spontaneously ingests. Indeed, IV fluids infused at the usual rates can worsen suffering by stimulating gastrointenstinal and respiratory secretions. A dying patient's need for pain medication often diminishes, but may occasionally escalate.