I just started hospice nursing and think I am going to like it. Just wondering at what point do we discontinue medications and only give comfort meds?
I think it really depends on the wishes of the patient and the family. Do the meds (other than comfort meds) improve quality of life for the patient? If yes, and the patient is able to take them safely, then they can be continued.
I would say that once the patient is no longer able to swallow or take PO meds safely, or the individual medication is no longer adding to QUALITY of life, that would be the time to talk about discontinuing those meds.
Things like cholesterol meds, Synthroid, etc I encourage DC relatively early like at SOC b/c it will make no long-term difference and isn't for comfort. Something like Lasix or Ditropan can be used for comfort, so I encourage those to be continued as long as they can swallow. Lovenox we continue if they're "with it mentally" if there's an active PE b/c otherwise you may be setting them up for an uncomfortable death. Once pt can no longer swallow comfortably, of course DC everything except comfort meds, ie Roxanol, At I van, Levsin, etc.