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Applied Medical Research ISSN: 2149-2018
Applied Medical Research. 2021; 8(1):(85-120)


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.