Page 20 - TERMINAL DISCHARGE GUIDELINE FIRST EDITION 2023

Chapter 6
Medication

Chapter 6 Medication
Service Provision

1. To assess patients who are deemed to be in the dying phase

(prognosis of hours to days) and explore their preferences for
preferred place of care and death. If their preference is home and
the environment is suitable, to prepare for terminal discharge.

2. To educate family and caregivers regarding Caregiver Training
(CGT) which includes nursing care and medication administration
and to ensure that they are competent to ensure patient’s comfort

at home.
3. To de-prescribe medications that are futile, potentially harmful, little
or no benefit.
4. Assess symptom and prescribe medication via the sublingual,

subcutaneous (pre-filled single dose syringes) or transdermal route
as during end of life, swallowing may be difficult and absorption may
be impaired. These medications include opioid, benzodiazepine,

atypical antipsychotic (as per the following page).
5. To supply medication (symptom control) for a total of 5 -10 doses or
a period of 5 - 14 days for terminal discharge.

6. If additional medication is required, the family or caregiver should
consult the Primary team or Palliative Care team doctor for
assessment and plan to collect the refill medication via appointment.

7. Prescription, supply, preparation, storage, return and disposal of
medications should be done in accordance with Medication Use and
Safety (Appendix).

HOSPITAL KUALA LUMPUR 20
TERMINAL DISCHARGE GUIDELINE 2023