Delirium is a common neuropsychiatric syndrome in patients with advanced cancer and its prevalence increases significantly in the last hours or days of life. Terminal agitation, a symptom of delirium, can be distressing for patients, their families and the nurses caring for them.

This article explores the assessment of delirium and terminal agitation as the first step in alleviating symptoms, highlighting the need for a comprehensive, holistic assessment using validated tools. It emphasises the importance of prioritising non-pharmacological approaches – such as environmental modifications, orientation and reassurance – to manage terminal agitation, as well as the importance of considering the wishes and preferences of patients and families. The article also examines the emotional burden on nurses and the need for self-care, reflective practice and organisational support.

By better understanding terminal agitation and its assessment and management, nurses can enhance the care of patients at the end of life, support families and mitigate their own psychological distress.