Expectations of hospice

Leanna

Hi,

My mom has been in hospice for 6weeks and they recently increased her anti-agitation/anxiety meds by quite a bit and are not letting me as poa have say in if it is too much or not. I want to be respectful of staff at her facility and make sure they are safe providing cares but also do not want her to be overly medicated. It feels they are erring on side of later and not listening to me or wanting to change things. Is this normal?

harshedbuzz

Leanna—

There's not really enough information in your post to get a sense of what, exactly, is happening.

Is your mom on hospice because of end-stage dementia or is there some other medical condition (cancer, CHF, or lung issues), in addition, causing her distress?

What are her "anti-agitation/anxiety meds? Are you talking SSRI, atypical antipsychotic, benzo or something else entirely? Is your mom's medication prescribed daily or "as needed"? What was she taking prior and what is she taking now?

What does "over-medicated" mean to you? Are you seeing more sleeping or less responsiveness which could also be a result of disease progression? Sometimes doses need to be increased because the medication is not as effective as it was either because she's developed a tolerance or because her brain is more damaged from disease progression.

Behavior is communication. If she's lashing out, she's in considerable distress. You reference staff being safe in providing care; is your mom physically agitated enough to risk injuring staff? If so, that's a biggie. The facility needs to protect their people. You risk mom being turfed to a geri-psych unit and not able to return to her current facility with you scrambling to find another place willing to accept her as a resident with a history of behaviors.

That said, if you are truly unhappy with this hospice, you could bring in a different provider.

HB

Leanna

https://alzconnected.org/discussion/comment/210922#Comment_210922

i appreciate your feedback. Yes she was being aggressive/resistant to cares which is why they needed to increase meds.

Jeanne C.

We recently increased my husband's med dosage due to aggression. Besides safety, I feel like it's kinder than letting him be so agitated his only way to communicate is by trying to hit me or his aide. I did discuss it with his hospice team before we made the change. I know you're worried about "overmedicating" her but you should also consider her comfort and how she must be feeling to be so agitated. That being said, you do have final say as her POA.

Smilescountry

I was told that no medications would be given to my father without my consent. In fact, they are not keeping a "comfort kit" at the facility for Dad because it was misused another time for him and caused a bad reaction. I am not opposed to comfort kits when they are used properly, but this was not the case. I would certainly listen to the people who are caring for your dad. If there is aggression that cannot be addressed in any other way, then he probably needs the medication. The way that I approached the new hospice that is taking care of my dad is that I was not opposed to changes in medication but that I did want to be kept informed of what was going on. I explained that he was on one medication that interacts with almost all anti-anxiety medications and some pain medicines and that if the anti-anxiety medications were necessary then we needed to consider weaning him off the medication that he is currently on.