Treatments That Can Be Continued on Hospice Care

Determining the primary hospice diagnosis is crucial as it guides the overall care plan for the patient’s specific needs. It’s also important to determine if the treatment is curative or comfort focused, aligning the care with the patient’s desired outcomes. Taking the goals of the patient or family into account allows for personalized and patient-centered care, promoting satisfaction and improved quality of life. Assessing the risk vs benefit of treatment or medication ensures informed decision-making, optimizing patient outcomes. Additionally, reviewing current medication is vital to minimize risks, identify interactions and optimize the medication regimen to ensure patient safety and well-being.

Treatments Related to the Primary Hospice Diagnosis

Determining if the treatment, care or medication is related to the terminal diagnosis is necessary in providing appropriate conversations that address the specific needs and symptoms associated with the end-stage condition. This targeted approach maximizes patient comfort, quality of life and overall satisfaction during the end-of-life journey.

In certain cases, treatments that are typically discontinued may be continued if they are directly related to the primary hospice diagnosis or related conditions. These can include:

• Wound vacs and aggressive wound treatments to manage specific wound-related symptoms.
• Palliative Chemotherapy or radiation to alleviate cancer-related pain or symptoms.
• Limited use of IV therapies for palliative purposes.
• Selective use of blood transfusions to address symptom management.

Comfort-Focused Treatment

While curative treatments are generally discontinued in hospice care, many comfort-focused treatments can continue. These treatments focus on managing symptoms and improving the patient’s quality of life, rather than curing the underlying condition. Examples of comfort-focused treatments include:

• Pain management medications
• Hospice-specific medications
• Relaxation techniques and music therapy
• Physical therapy and rehabilitation

Continuing Medications in Hospice Care

A thorough review of the patient’s current medications is conducted to assess their relevance and effectiveness in hospice care. Certain medications may continue based on the patient’s needs, including:

• Pain relievers for managing pain
• Anti-nausea medications for alleviating nausea or vomiting
• Anti-anxiety medications for reducing anxiety or restlessness
• Antidepressants for managing depression or mood changes
• Steroids for symptom management in conditions like cancer or COPD
• Medications targeting respiratory symptoms in conditions like COPD or congestive heart failure

Risks vs. Benefits of Treatment or Medication

Assessing the risk versus benefit of continuing a certain medication or treatment is a fundamental aspect of medical decision-making, particularly when considering the patient’s overall status and prognosis. In advanced stages of a terminal illness, the patient’s declining health and limited life expectancy can greatly affect the potential benefits of aggressive solutions.

Some important things to note include:

• Individualized Approach: Each patient’s situation is unique and it is essential to evaluate the risks and benefits on an individual basis, considering factors such as the patient’s overall health, prognosis and goals of care.
• Balancing Risks and Benefits: Aggressive treatments may carry potential risks, such as harmful side-effects, hospitalizations or reduced quality of life, which may outweigh their potential benefits.
• Comfort-Focused Care: Shifting towards comfort-focused care emphasizes managing symptoms, improving quality of life and providing emotional and psychosocial support. This approach prioritizes the patient’s well-being and dignity, reducing unnecessary burdens and suffering.
• Patient-Centered Decision Making: Collaborative discussions between providers, patients and their families are crucial in determining the most appropriate treatment approach. Understanding the patient’s values, preferences and goals helps guide decisions and align the care plan with their needs.
• Multidisciplinary Approach: Involving a multidisciplinary team, including physicians, nurses, palliative care specialists and other healthcare professionals can ensure comprehensive and holistic decision-making.

By carefully weighing the risk versus benefit, healthcare providers can make informed decisions that optimize the patient’s well-being and quality of life. Prioritizing comfort-focused care over aggressive treatments allows for a more compassionate and personalized approach, enhancing the patient’s end-of-life experience.