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Column: Medications don’t need to change with hospice care

By Jennifer Black, Compassionate Care Hospice

Welcome to the 11th in a series of articles that exposes common myths and misconceptions surrounding hospice care.  The goal of this series is to set the record straight by addressing these myths with honesty and integrity. Our hope is that the education provided here will lead to families and caregivers having the necessary information to engage in open conversations with their loved ones about end of life care.

Myth No. 11: “I will have to stop taking all of my medications if I come onto hospice” and “I will not have the same nurse from week to week.”

It is not a hospice requirement to discontinue all medications upon admission to hospice. Once the hospice RN Case Manager has completed the assessment and admission, the medication list would be reviewed to determine which medications are related to the primary hospice diagnosis and which ones are not related. Medications that are related to the primary hospice diagnosis are typically paid for by the hospice with a few exceptions. Medications that are not related and/or not covered by hospice could still be paid for by Medicare Part B. Any medications that are considered aggressive or curative in nature may not be covered by Medicare and could become the patient’s responsibility for payment if they choose to continue taking them while on hospice.  

The hospice RN Case Manager then reviews the medication list to determine what medications the patient is currently taking that may not be needed for palliation of care. The RN Case Manager would then discuss these medications with the patient and/or family to determine if any medications could be discontinued based on patient/family wishes.

There are times when a patient is admitted to hospice and the patient is no longer able to swallow. If a patient is minimally responsive and death appears imminent, then all medications could be discontinued and the patient could receive comfort medications in a liquid or dissolvable form.  

Remember, the philosophy of hospice care is to promote comfort. Discontinuing needed medications for heart or pulmonary issues, for example, could make the patient much more uncomfortable. The same is true for patients who may be unable to swallow. These patients could be at an increased risk for discomfort caused by aspiration that could lead to pneumonia.

Hospice is also about building relationships with our patients and their families. Consistency with hospice staff is vital to building and maintaining that relationship.  Except for an illness or vacation, patients should expect to see the same staff from day to day and week to week!

Come back next month for Myth #12: “Hospice only cares for me and not my family” and “Hospice will abandon my family as soon as I die.”

Jennifer Black is director of clinical services at Compassionate Care Hospice. Email questions, comments or suggestions to jennifer.black@cchnet.net or call 1-877-372-7003.