I am actually posting this for a friend, a hospice nurse who sadly has to work with a doctor who is not real knowledgable or savvy about hospice. She has heard that some docs prescribe Decadron for it's euphoria and appetite stimulating effects, even if the patient doesn't have bone pain, brain mets, etc. Anyone know about this? Doses? Typical patient responses? Thanks for any help, and I will forward this on to her (and encourage her to join!). Kim
Aug 5, '04
I occasionally see Decadron or Prednisone used as an appetite stimulant in terminally ill patients. It can improve appetite, but usually the effect does not last long. Some patients and families are so upset about anorexia that it is worth a try, even with the side effects. Megace is also used sometimes, but is much more expensive. These are often meds that have come along for the ride from chemo or radiation and nobody has stopped them even though they probably aren't doing much good by the time hospice steps in. I personally feel that emotional support and instructing to accept the changes brought about by the disease process is a more appropriate hospice type treatment. However, many physicians continue to offer drug panaceas rather than have those uncomfortable conversations. Leaving the mess, of course, to be sorted out at the end by the hospice nurse.
BTW, before ordering steroids, you should look causes of anorexia that can be fixed, like oral thrush, nausea, constipation, hypercalcemia, or psychological issues.
Last edit by hospicenurse on Aug 5, '04