Understanding the progressive nature of dementia can help in the decision to continue or discontinue dementia medications in patients on hospice care for end-stage dementia. Goals change as patients progress from mild to severe dementia. In mild to moderate dementia, the primary goal is to slow the progression of the disease. As dementia nears its…
Hospice patients often communicate allergies to medications. When the medication is an opioid, hospice staff often have to determine whether the reaction that the patient believed to be an allergy is truly an allergy and whether the reaction necessitates the avoidance of certain opioids. True allergies involve an immune response; other reactions can fall into…
The ever-increasing awareness of the dangers of hypnotic use in the elderly leaves many patients, prescribers, and caregivers hesitant to initiate prescription medications to treat insomnia. Combined with the increased awareness and use of natural vitamins and supplements amongst hospice patients, many hospices are finding it desirable to utilize melatonin in certain patients having difficulty…
The Institute for Safe Medication Practices (ISMP) has long recognized the frequency of mix-ups resulting from the non-standardization of units utilized in measuring volume of oral liquid medications. Since 2009, ISMP has strongly encouraged all practitioners to solely utilize the metric system for measuring oral liquid doses. The National Council for Prescription Drug Programs (NCPDP)…
Medication cost, adverse effects, and poor therapeutic response often necessitate switching a hospice patient from one antipsychotic to another. Prescribers can choose among several options when a switch is necessary. Abrupt switch: Often preferred by hospice prescribers, one antipsychotic can be abruptly discontinued with the immediate start of a new antipsychotic at a therapeutic dose.…
Understanding the progressive nature of dementia can help in the decision to continue or discontinue dementia medications in patients on hospice care for end-stage dementia. Goals change as patient’s progress from mild to severe dementia. In mild to moderate dementia, the primary goal is to slow the progression of the disease. As dementia nears its…
If ever there is a time for compassionate medicine, it is when a patient is nearing the end of life. Unfortunately, when hospice becomes involved in patient care and recommendations are made for the discontinuation of medications, patients and caregivers alike can feel abandoned. They may feel as though the discontinuations will hasten death, worsen…
Despite the American Medical Association’s stance that “cannabis is a dangerous drug and as such is a public health concern,” the use of medical cannabis, or medical marijuana, is increasing. With the legalization of marijuana in various states and the availability of marijuana and/or cannabidiol for medical purposes in over twenty states, hospice providers are…