Sepsis in Hospice: Recognizing End-of-Life Signs

Facing the final stages of a loved one’s life is an incredibly difficult experience. However, knowing what to expect from hospice care can go a long way to helping families and caregivers prepare. Hospice can be tailored to a wide range of conditions, including severe infections that eventually lead to sepsis. Learn more about how this level of care helps people live out their final days as comfortably as possible.

How Sepsis Affects the Body

When an infection develops into sepsis, the body releases chemicals into the bloodstream to fight the threat. In a healthy person, this response is protective. In a hospice patient, who already has a fragile immune system, this extreme immune response triggers inflammation. That inflammation then causes blood clots, which block nutrients and oxygen from reaching the vital organs. Over time, the organs shut down, and hospice providers shift their focus entirely to symptom management and comfort care.

Recognizing Physical Symptoms of Sepsis

How do you know when a loved one has reached the end stages of life due to sepsis? As the body shuts down, you may notice several changes in your loved one. These are normal, and their hospice team will work to ensure your loved one stays as comfortable as possible:

Changes in Breathing Patterns—You might notice your loved one’s breathing becoming very shallow or rapid. There may be periods where breathing stops entirely for ten to thirty seconds, followed by a deep, sudden gasp. While this sound can be distressing to hear, it doesn’t typically mean your loved one is in any pain.
Skin Temperature and Color Changes—During the final days of life, a patient’s heart will weaken and their blood pressure will drop. When this occurs, the body prioritizes sending blood to the brain and heart, leaving the extremities without normal blood flow. Your loved one’s hands and legs might feel cold, and their skin might look pale or blotchy due to this lack of blood.
Decreased Need for Food and Water—The body requires a vast amount of energy to process food and fluids. As organs shut down, the digestive system slows to a halt. Your loved one may lose their appetite and stop feeling thirsty. Swabbing their mouth with a damp sponge or applying lip balm can keep them comfortable without overwhelming their system.

Behavioral and Mental Shifts Related to Sepsis

Home care for sepsis doesn’t just alleviate physical symptoms. Sepsis also presents some behavioral and mental challenges. Your loved one’s hospice team will help them manage these potential effects:

Lethargy—Patients in the final stages of sepsis might sleep for the majority of the day, and eventually, they might slip into unconsciousness.
Confusion— The combination of organ failure, reduced oxygen to the brain, and the infection itself can cause delirium. Your loved one might seem confused about where they are or who is in the room.
Restlessness—Some people with sepsis become physically restless and feel the need to pull at their blankets or clothing.

The Role of the Hospice Team

The hospice care team is key to managing sepsis symptoms. While they don’t administer aggressive or curative treatments, they do go the extra mile to ease pain, reduce fever, and calm anxiety. If your loved one has a hard time breathing, they might provide small amounts of oxygen or medication to help. The team is also there for you as you come to terms with your loved one’s condition and ask questions about what comes next.

Supporting Your Loved One Through the Final Stages

While you can’t stop the progression of a life-limiting illness, you can provide support to your loved one in the final stages. That support might look like holding a hand, lending an ear, or just being present. At Agape Hospice & Palliative Care, we’re here for you and your loved one as you navigate this difficult time. Get in touch with us today to learn more about how we support families in Los Angeles and Orange Counties.

Frequently Asked Questions

Is sepsis painful at the end of life?

Sepsis itself is not necessarily painful, but the underlying infection or inflammation can cause discomfort. Hospice teams are highly skilled at recognizing signs of distress, such as grimacing or moaning, and will use medications to keep your loved one as pain-free as possible.

Can sepsis be treated in hospice care?

The philosophy of hospice is to prioritize comfort over curative treatments. While minor infections might be treated with oral antibiotics early in hospice, severe sepsis at the very end of life is typically not treated with aggressive medical interventions, as the burden of the treatment often outweighs the benefits.

How long does the final stage last?

The timeline varies depending on the patient’s overall strength and the severity of the infection. Once severe sepsis sets in and multiple organs begin to fail, the end-of-life stage usually lasts anywhere from a few hours to a few days.

What are the signs of discomfort to look for?

During the final stages of sepsis, caregivers should watch for signs of respiratory distress, such as labored breathing, as well as physical restlessness or furrowed brows, which may indicate pain. If you’re concerned about discomfort, be sure to talk to your loved one’s care team.

Can a patient recover from sepsis while in hospice?

Patients in hospice with sepsis are unlikely to recover. The goal here is comfort care, which focuses on maintaining your loved one’s dignity and supporting you through the process.

Sepsis in Hospice: Recognizing End-of-Life Signs