Cheyne-Stokes and haldol?

mc3, ASN, RN · Dec 27, 2009

Haldol is generally in the comfort kit in case of severe terminal restlessness/agitation. I've rarely had to use it but glad it was there when I did.

mc3:paw:

tewdles, RN · Dec 28, 2009

My aunt is in end-stage COPD and on home hospice and was just prescribed haldol. My mom and I are trying to figure that out. Is it to ease some kind of delirium or something else? I've never heard of it used outside of psychiatric cases, so I couldn't help any.

There are a couple of specific reasons that we use haldol for COPD patients. Remember that comfort is the primary goal for most hospice patients and use that thought as a back drop for most discussion of hospice medication use.

It is common for COPD victims to suffer from other unpleasant symptoms besides shortness of breath; anxiety and nausea are two examples. Constipation would be a significant third. Your aunt very likely suffers from these symptoms as well as dyspnea, fatigue, cough, dysphagia, weight loss, etc.

Haloperidol is commonly used in routine hospice care for the treatment of nausea and of agitation. In low doses, most hospice patients enjoy the benefits of this drug with relatively few unpleasant side effects. Please note the emphasis on unpleasant...this highlights the perspective of the patient in these decisions. For instance, a patient may use haldol successfully for nausea and find that the mild drowsiness or sedation is tolerable, at least for awhile. Ultimately it should be up to your aunt or her MPOA as to which medications she is using for her comfort.

It is good that you have questions about your aunt's care. I hope that you will talk with her hospice case nurse when you see him/her. The hospice team is very interested in you and your mom...your aunt's family.. understanding what it means that your aunt chose hospice support for the end of her life. Her hospice team will want to help you understand what is going on, and how you fit into that for your aunt.

Good luck to you. I hope you find some peace in your aunt's journey.