23/04/2026
Palliative Sedation
Q.
Gabby, could you share your thoughts on palliative sedation in hospice? What does this mean?
A.
Dear…
When we hear the words “palliative sedation,” it can feel heavy. And truthfully, it often comes at a time when things already feel heavy, when someone we love is struggling, and what we are doing to help just isn’t enough.
At its core, palliative sedation is about relieving suffering when nothing else is working. It is used when the pain, the agitation, or the distress can’t be controlled with the usual medications when the body is nearing the end.
Something that is really important to say here is this, it is not always the person in the bed making this decision.
Sometimes it is. Sometimes a person is awake, aware of their suffering, and able to say, “this is too much,” and they agree to be sedated for comfort.
But more often, it is the people who love them who make this decision.
It is the family standing at the bedside, watching someone they love struggle to breathe, or unable to settle, or showing signs of deep discomfort despite everything being given. It is the moment where they realize the medications are no longer enough.
“Isn’t there something else we can do to make them more comfortable?” 
This decision is not about giving up.
It is about asking, how do we ease this?
Palliative sedation gently lowers a person into a deeper level of rest so they are not experiencing that intensity of discomfort. It is not meant to hasten death, it is meant to soften suffering.
It doesn’t always look the way people expect, it isn’t always a peaceful moment followed by a quick passing.
Sometimes it takes time.
Sometimes it’s hours.
Sometimes it’s days.
And during that time, families sit… and watch… and love… and wonder if they did the right thing.
If you are in that place, I want to speak directly to you:
Making the decision to prioritize someone’s comfort when they can no longer speak for themselves is one of the most loving, and most painful, acts there is.
You are not choosing this lightly.
You are choosing it because you have witnessed enough to know they shouldn’t have to keep feeling this way.
There is no perfect way to walk through it. There is no moment where it suddenly feels “okay.” Choosing to ease suffering is an act of deep care.
Stay close to them. Speak if you want to. Sit in silence if that’s what feels right. Your presence still matters, even if it feels quiet and uncertain.
And please, be gentle with yourself in the days that follow. This kind of decision stays with you, but so does the love that led you there.
xo
Gabby
www.thehospiceheart.net
