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Column: Main goal of hospice -- monitor symptoms, maintain comfort

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 #11: “I will be forced to stop taking all of my medications if I come onto hospice” and “I will not have the same nurse from week to week.”

This is a big one! Hospice does not automatically discontinue all medications upon admission to hospice. There is a process, but first let’s review some of the rights we have as patients: Having the right to choose our own provider of health care, the right to participate in our plan of care, the right to receive as little or as much care as we wish, the right to take medications or not.  

That being said, every hospice patient is unique as to where he/she is in the dying process and there are many situations to consider. It is the responsibility of the hospice RN Case Manager to discuss medications with the facility, physician, patient and/or family when creating the hospice plan of care. Based on the RN’s assessment of the hospice patient, input from the caregivers and education provided by the RN, a recommendation would be made on what medications to continue, what medications to add and/or which medications to stop. It is ultimately patient and/or family choice. When a hospice patient becomes unresponsive and is no longer swallowing, yes, all medications would be discontinued for the safety of the patient. Medications needed to maintain comfort would remain.

The main goal of hospice is to monitor symptoms and maintain comfort. Consistency and relationships are key to achieving that goal. The best way to achieve that goal is to have the same nurse and other staff visiting from week to week. This consistency builds a relationship between patient and hospice. Hospice staff are then able to “know” their patients and recognize when the level of comfort may need to be adjusted.

February is Heart Month!  Come back for Myth #12: “If I start taking morphine on a regular basis for my cardiac disease I will become addicted.”

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