Administration of Intranasal Midazolam for Anxiety in Palliative Care

This study is evaluating the use of midazolam (a sedative medication) delivered through a nasal spray to quickly relieve sudden episodes of severe anxiety in palliative care patients — people receiving end-of-life or comfort-focused care. Intranasal delivery is fast, non-invasive, and may be easier than injections for patients in this situation. Researchers want to confirm how well it works, how safe it is, and how it is absorbed by the body. **You may be eligible if:** - You are an adult (18+) receiving palliative care at one of the participating hospitals - You have a sudden episode of acute anxiety, and your doctor has decided intranasal midazolam is appropriate for you - You are able and willing to give written consent and complete anxiety assessments **You may NOT be eligible if:** - Midazolam is being prescribed for seizures or continuous sedation - You have an allergy or known sensitivity to midazolam or benzodiazepines - You have had a paradoxical reaction to midazolam (meaning it made you more agitated instead of calmer) - You have acute narrow-angle glaucoma (a specific eye condition) - You have nasal obstructions (such as nasal tubes, polyps, or blockages) that would prevent absorption - You are taking certain medications that strongly interact with midazolam - You were recently started on strong opioid pain medications Talk to your doctor to see if this trial is right for you.