End of Life Care Involves Drugs: What You Need to Know

International Overdose Awareness Day is August 31 this year, a day dedicated to remembrance, awareness, education, and action to help eliminate overdose deaths, according to the National Safety Council. This is your chance to help raise awareness, memorialize a lost loved one, save lives and inspire change. As you may know, if you have a loved one in hospice in Santa Clara and elsewhere, end of life care often involves a variety of medications to help them feel comfortable — some of which can be highly addicting if in the wrong hands.

Drugs as part of hospice are normal. Medication is prescribed and administered by licensed medical doctors and nurses in the proper doses to ensure the patient can pass through each end-of-life stage in as much peace and comfort as possible. The problem enters when effects aren’t monitored, proper handling and disposal practices of drugs are not followed, and when prescription drugs are stolen. Hospice providers like Pathways Home Health and Hospice follow a strict set of protocols to ensure the proper handling, safe administration, and vigilant monitoring of all medications used for patients within a highly controlled environment.

Morphine and Respiratory Distress

Morphine, a drug that relaxes the muscle walls of blood vessels, increases capacity and reduces the lungs’ urgency to struggle to breathe. Coronary arteries are then more efficiently able to carry oxygen-rich blood away from the heart. This drug is often prescribed to ease hospice patients’ breathlessness, which can be even worse than pain, paralysis, or the inability to move around. However, too much morphine can stop the lungs completely, so only a tiny amount is necessary. It’s a fine balancing act, one that could kill a patient before their time if administered in too high of a dose.

Hospice clinicians understand this and are diligent in making sure this doesn’t happen. No one wants to risk killing someone, even if it means seeing their loved ones suffer. That’s why it’s so important for hospice care providers to communicate the methods, goals, and expectations of using morphine. After all, misconceptions about what the drug can and cannot do can lead to unnecessary suffering for patients, points out Stat News.

Dying at Home During an Opioid Crisis

Stolen medication is another very real concern, especially surrounding family members who have loved ones in hospice at home. A big problem is afoot, but sadly it’s nothing new: as more people die at home on hospice, some of the most addictive, powerful drugs that are being prescribed for patients are ending up in the wrong hands. One example from Kaiser Health News tells a story of an elderly woman with severe dementia and inoperable breast cancer who was repeatedly asking for pain medication even though the hospice had been sending home painkillers for weeks. Not too long after, the woman’s daughter, who was her caretaker at home, came into the ER with a deadly overdose of morphine and oxycodone — her mother’s medications stolen from the hospice-issued supply.

Hospices have typically been exempt from the national crackdown on opioid prescriptions due to the simple fact that dying people need high doses of opioids. But with the worsening state of the nation’s opioid epidemic, many experts say hospices need to more diligently identify family members or even staff who could be stealing pills. Amid continually rising overdose deaths, many states have passed laws allowing hospice staff to destroy left-over pills once patients have passed on. This growing problem has spurred on the creation of policies, studies, new guidelines, and national discussions on the misuse and theft of drugs.

Hospice: Still the Best Alternative to Those Facing End of Life

Despite a few bad seeds in a world of largely honest, straightforward and moral family members and staff, hospice remains the best way to ease an elderly or terminally ill patient from the last stages into death. In fact, hospice has seen a dramatic rise in enrollment as more and more people choose to focus on comfort, instead of a cure, toward the end of life. This fast-growing industry is serving more than 1.6 million people per year. Dying is not pretty, nor is it pain-free. Medications are critical in easing the pain, broken bones, shortness of breath, or aching joints from lying in bed that many end-of-life patients face.

Better regulation on a national level and more watchdog advocacy within each hospice facility will have to continue in order to address and stem the flow of drug misuses, including screening families of patients for history of drug addiction. On the other side of the coin is the worry about restricting access to painkillers to those who truly need it. Hospices must strike a balance.

Pathways Home Health and Hospice is dedicated to ensuring the safe dispensing and monitoring of medications given to patients. Staff, including doctors and nurses, will speak to family members about any concerns regarding the specific drugs given at the end of life to ease loved ones’ suffering, including how to safely monitor and manage effects.

Contact Pathways Home Health and Hospice

The goal of hospice care is to relieve symptoms, control pain, and give patients the support they need to enjoy their remaining days as comfortable as possible. To learn more about our process and what to expect, contact us at 888-978-1306.