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Palliative cancer care - oral problems - Management
How should I manage oral care in the terminal phase?

  • Carry out mouth care as often as necessary to maintain a clean mouth. See Self care.
  • In unconscious people, moisten the mouth at least once an hour with water from a water spray, dropper, or sponge stick or ice chips placed in the mouth.
  • To prevent cracking of the lips, smear petroleum jelly (e.g. Vaseline®) on the lips. However, if a person is on oxygen apply a water-soluble lubricant (e.g. K-Y Jelly®).
  • When the weather is dry and hot, if possible, use a room humidifier or air conditioning.
  • Manage pain symptomatically, using analgesics via a suitable route. Stop treatment of the underlying cause of pain when the burden of treatment outweighs the benefits.
Clarification / Additional information
  • In people who are conscious, the mouth can be moistened every 30 minutes with water from a water spray or dropper, or ice chips can be placed in the mouth.
  • Dry mouth and thirst are very common in people who are dying, regardless of whether they are dehydrated. Reversing dehydration improves symptoms in only a small number of people [Ellershaw et al, 1995].
  • People in the last 24–48 hours of life often have difficulty taking food, fluid, or oral medication. Good symptom control may allow the dying person to eat, drink, and talk comfortably. Mouth care can easily be carried out by the family, giving them greater involvement in the care of their dying relative.
Basis for recommendation

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