When patients enter hospice care, the focus shifts from curing their condition to providing comfort and enhancing their quality of life. Medications play a critical role in this care, helping to manage pain, mitigate symptoms, and ensure the patient is as comfortable as possible. Hospice providers strive to create a carefully tailored plan for each individual, but certain medications are commonly used to address typical end-of-life symptoms.
This blog will explore the 10 most common medications used in hospice care, the conditions they address, and how they aim to improve the quality of life.
What Makes Medications Important in Hospice?
Hospice is all about improving comfort while respecting the wishes of the patient and their loved ones. At the end of life, symptoms can range from physical pain to nausea, breathlessness, agitation, and more. Medications in hospice are not just about alleviating physical suffering; they also help with emotional, psychological, and spiritual well-being by enhancing overall comfort.
These medications are often delivered efficiently, and hospice teams regularly assess their effectiveness and adjust doses to ensure optimal care.
10 Common Medications in Hospice Care
1. Morphine (Opioid Pain Reliever)
- What it treats: Severe pain and breathlessness (dyspnea).
- Why it’s used: Morphine is a staple in hospice care because of its ability to manage sharp, chronic pain effectively. It also eases breathing difficulties, one of the more distressing symptoms for terminal patients.
- How it’s given: Depending on the patient’s needs, it can be administered as a pill, liquid, or injection.
2. Acetaminophen (Pain and Fever Reliever)
- What it treats: Mild to moderate pain and fever.
- Why it’s used: Acetaminophen is a non-opioid alternative often used to control mild symptoms without causing drowsiness. It’s especially helpful for managing aches and fevers common in various conditions.
- How it’s given: Generally taken orally in pill or liquid form.
3. Lorazepam (Anti-Anxiety and Sedative)
- What it treats: Anxiety, restlessness, or agitation.
- Why it’s used: Known to reduce feelings of anxiety and induce calmness, Lorazepam is frequently prescribed when patients feel agitated or have trouble sleeping. It offers both emotional and physical relief.
- How it’s given: Available in oral tablets or injectable forms.
4. Haloperidol (Antipsychotic)
- What it treats: Nausea, vomiting, and agitation.
- Why it’s used: Often overlooked, Haloperidol is invaluable for controlling nausea that can come with cancer treatments or other terminal illnesses. It’s also used to reduce severe agitation or confusion in patients.
- How it’s given: Either orally or via injection.
5. Atropine Drops
- What it treats: Excessive secretions and difficulty swallowing.
- Why it’s used: These drops help dry up excess respiratory secretions, which can cause discomfort or the “death rattle” sound often heard in the final stages of life.
- How it’s given: Typically administered under the tongue for fast absorption.
6. Furosemide (Diuretic)
- What it treats: Fluid build-up caused by heart or kidney failure.
- Why it’s used: Furosemide helps patients urinate excess fluid, reducing symptoms such as swelling, difficulty breathing, or discomfort around the chest and abdomen.
- How it’s given: Administered in pill or liquid form and occasionally via IV or injection.
7. Senna (Laxative)
- What it treats: Constipation.
- Why it’s used: Constipation is a common side effect of both pain medications and limited activity levels. Senna, a natural laxative, helps regulate bowel movements without being overly harsh.
- How it’s given: Taken in pill or liquid form.
8. Metoclopramide (Anti-Nausea and Gut Motility Stimulant)
- What it treats: Nausea, vomiting, and delayed stomach emptying.
- Why it’s used: This medication is particularly useful for patients struggling with nausea due to medication side effects or digestive slowing. It also improves digestion, easing stomach discomfort.
- How it’s given: Taken as a pill or liquid, sometimes injected.
9. Dexamethasone (Corticosteroid)
- What it treats: Swelling, inflammation, and various symptoms like fatigue or poor appetite.
- Why it’s used: It reduces inflammation and can help improve energy levels, making patients feel more comfortable and alert.
- How it’s given: Administered orally, intravenously, or as an injection.
10. Hyoscyamine (Antispasmodic)
- What it treats: Muscle spasms, abdominal cramping, and excessive secretions.
- Why it’s used: Hyoscyamine helps relieve painful cramping in the stomach or intestines and, like Atropine, can minimize respiratory secretions.
- How it’s given: Typically taken in tablet or liquid form.
The Role of the Care Team in Medication Management
Caregivers and healthcare providers are vital in ensuring that these medications are used effectively and safely. Every medication listed above is carefully dosed and monitored, with adjustments made as the patient’s symptoms evolve. Hospice staff also educate families and caregivers to ensure they feel supported and confident in administering medications.
What Diagnosis Qualifies for Hospice Care?
Hospice care is designed to provide comfort and support for individuals facing a terminal illness, typically with a prognosis of six months or less if the disease follows its natural course. Among the most common diagnoses that qualify for hospice care are advanced cancer, late-stage heart disease, chronic obstructive pulmonary disease (COPD), and Alzheimer’s disease or other progressive dementias.
These conditions often lead to a significant decline in physical health, making symptom management and quality of life the primary care focus. By addressing the unique needs of patients with these diagnoses, hospice care ensures that they receive compassionate medical attention, emotional comfort, and support for their families during this challenging time.
How to Offer Better Comfort
For families, understanding these medications can help alleviate worry and empower you to provide the best experience for your loved one. Always communicate with your hospice care provider about any concerns or changes in symptoms.
Medications are powerful tools, but your care and compassion are equally important in making this time as meaningful and comfortable as possible.
