Applied Medical Research. 2021;
8(1):(85-176)
The Importance of Appropriate Management and Differential Diagnosis Patient’s Vocalizations (Groaning or Moaning) In the Last Days and Hours of Life
Luciana Frade
Abstract
In the last days of life, patients often present with disorganized vocalizations, repetitive and
incomprehensible sounds, which are often interpreted as a sign of discomfort primarily
for the patient, but also for everyone involved in his/her care. In this context, groaning
is not only, but often, linked to behavioral disorganization and psycho-motor agitation
(pre-terminal delirium), representative of a path of clinical deterioration that can manifest
itself in different ways. Therefore, there is an urgent need to identify the aetiology at the
base of these vocalizations (moan/groan) in order to properly address it with correct nonpharmacological
and pharmacological approaches. This article, in the format of a narrative
review aims to gather data with clinical relevance, namely aetiology, approach and impact
of this important symptom, in order to change incorrect practices, improve the quality of
care and provide practical guidance.
