Hospice/ meds

Saya_G

We’ve placed our mom on hospice, learning a lot about the offering.

Once placed on hospice, all dementia meds are quit - if the loved one is on hospice because of dementia. 

Sooooooo, my question is do you all really thing the meds help? My Fam doc says not much. I’d love to hear what you all think.Thanks, 

Saya

Stuck in the middle

Namenda and Aricept seem to increase the level of function, but don't delay the ultimate outcome of the disease.  DW has taken them for five years, and has been in Stage 4 for about three years.  Since Stage 4 typically lasts only 24 months, I think the meds help her.  For now.

Since your LO is on hospice, the meds probably aren't helping any more.

I'm not a doctor, just based on my experience with one person.

abc123

My mom has been on hospice about 4 weeks now. She can continue her dementia meds but we pay for them out of pocket. She is stage 7. I'll let my dad make that call.

quartlow2

My parents buy supplemental insurance that pay for meds with a small co-pay. So the meds that we agreed to keep them on, that Hospice won't cover, are still available. The Hospice Dr prescribes them when the refills from their previous Dr's run out. If the Hospice Dr isn't comfortable prescribing a particular med, we've been able to work with their other Dr's to get it renewed. With some cohersion they are willing to work with us because they are on Hospice and in MC and it's a major ordeal to get them to the Dr's office. Telemed or Telephone visits are sometimes still done. Some Dr's require more pleading than others. PCP's and FNP's are easier to convince than specialists.

Saya_G

Interesting that some of you are still allowed to supply dementia meds - I was specifically told that since she is under hospice for dementia we are not to give mom dementia meds. My mother has prescription insurance, but I was told that I could NOT buy the meds on my own, or she would be kicked out of hospice.

We live in Texas - are there different rules for different states?

Thanks,

Saya_G

dayn2nite2

Dementia medications are useless anyway.  Don't worry about going without.  IMO you may as well flush them down the toilet for all the good they do in PWD.

Your main goal here should be peace and comfort in the last part of your LO's life and medication for dementia is another pill that they have to take (and again, does not do anything to enhance their life).

Cynbar

Saya, the hospice staff are trusted advisors but the family are still in charge. It's true that hospice philosophy is comfort care and a patient can be discharged for pursuing curative treatments or medications such as oral chemo, but that threat sounds pretty harsh for something as innocuous as dementia meds (especially if you agree to pay for them through her regular insurance.) In our case, my DH's dementia meds were covered by hospice. With that said, I have never been sure how much they helped him since the point is mostly to slow progression. So, no, all hospices do not require a patient to stop them. It shouldn't matter what state you are in.

jfkoc

Myth #4: Hospice makes patients stop all of their medications

https://hospice.org/pgy2_year3myth4/

King Boo

The work of these medications is usually done by the time a person qualifies for hospice, provided the reason for receiving hospice is dementia.

These medications are used to hopefully plateau a person for a longer time period at an earlier stage of the disease, which presumably holds better function and quality of life.  They do not stop the advancement of dementia.  We had an usually long plateau at Stage 5; after that, things progressed as expected.

We discontinued these medications when we began Palliative care as he slept so much of the day, and they were also not used while on Hospice.  Unless you were to notice a huge change after they were stopped that you could not attribute to just being at a later stage and  a hospice patient, it's fine to let these go.  

Things change. 

mommyandme (m&m)

My mother has been with hospice since February.  She still takes her dementia meds.  Their philosophy seems to be if she’s comfortable then don’t fix what’s not broken.  Maybe they help, maybe they don’t.  The nurse is coming today for her weekly visit.  I’m going to ask her about it again.