Dealing with a Fever During the Dying Process in Hospice

Hospice training is an essential aspect of caring for terminally ill patients. One of the critical challenges caregivers and nurses face is end of life fever management. This article will discuss how to manage fever in hospice patients, including when to take a patient’s temperature and administer antipyretics.

hospice patient with fever

Understanding End of Life Fever in Hospice Patients

It’s important to understand that as a person approaches the end of life, their body begins to shut down, and their immune system weakens. This can make them more vulnerable to infections and illnesses that bring on a fever. A fever is defined as a body temperature above the normal range of 97.7°F to 99.5°F (36.5°C to 37.5°C). But the normal range may be lower in hospice patients due to their weakened state. It’s also worth noting that sometimes low-grade fevers don’t cause discomfort, so they don’t need to be treated with antipyretics.

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Assessing Fever in Hospice Patients

Assessing whether a hospice patient has a fever can be challenging because some hospice professionals may not want to disturb them. If the patient cannot hold a thermometer in their mouth, you can use axillary or rectal methods instead. However, if the patient’s extremities are cold from decreased circulation, it may be hard to assess by touch alone.

hospice caregiver helping patient with fever

Treating Fever in Hospice Patients

Suppose the patient is experiencing symptoms associated with elevated temperatures, such as sweating, chills, or agitation. In that case, it may be necessary to administer antipyretics as a comfort measure. Acetaminophen or ibuprofen can help reduce fever and alleviate discomfort. It’s crucial, though, to closely monitor the administration of these medications, as some may have adverse effects on patients with underlying conditions. Additionally, patients who are actively dying may become very uncomfortable due to high fever, and antipyretics may not be effective. In such cases, tepid sponging or cooling blankets may provide relief.

Understanding how to assess, treat, and manage fever during dying is essential in providing compassionate care. Consider hospice training online for you and your hospice team to learn these skills and be prepared for treating end of life fever in hospice patients. Online training offers flexible and self-paced courses covering symptom management, end-of-life care, and communication with patients and families.

We hope this article helped you care for your hospice patients; if so, please share it with your friends!


What causes fever at end of life?

Fever at the end of life can have many causes – infections, inflammation, and a body’s reaction to certain drugs. The body’s decreasing ability to maintain temperature also plays a role.

Does temp go up or down before death?

Body temperature can fluctuate before death. In the final stages of life, it is common for body temperature to drop as the body loses its ability to regulate temperature. However, the temperature may increase before death in some cases, particularly during an infection or fever. Each individual’s experience may differ, and hospice professionals are prepared for both conditions.

Does temperature spike before death?

Temperature spikes before death may not be a universal occurrence. A fever may be present due to a bacterial or viral infection, which could increase body temperature. It’s essential to consider that other factors, such as medical conditions or patient variability, may influence body temperature. Therefore, relying solely on a temperature spike as a sign of an impending demise is not advised.

Is fever a symptom of end of life?

Fever is not specifically an indication of the end of life. It can be a sign of an infection or sickness. In end-of-life care patients with terminal illnesses, however, fever may arise as their immune system deteriorates and is unable to fend off infections.

What is terminal fever?

Terminal fever, also known as “deathbed fever,” describes a rapid body temperature increase in the dying process’s final stages. This fever often results from the body’s weakened immune system and inability to regulate temperature or fight infections effectively. Terminal fever is not a specific disease but a symptom experienced by some patients nearing the end of life. Various underlying conditions can cause it.

Why do we get fever at the end of life?

A weakening immune system can cause a fever at the end of life. A weaker immune system makes patients more susceptible to infections. As the body fights off pathogens, it raises its temperature to create an inhospitable environment. Certain medical conditions, medications, or inflammatory processes can also contribute to fever in end-of-life care patients.

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