Home Hospice

[NelleG]

I am with a parent who is at home on Hospice. Is it legal/ethical/moral/ok? for me to push IV meds? I would rather do IV than watch him struggle with PO. I do have a nursing license in the state he resides, if that matters.

[RNperdiem, RN]

Start by calling your hospice nurse.

PO can be given in low volume or dissolve under the tongue form. My Dad was on a mix of morphine and sedatives for his last week and we were able to keep him comfortable on po meds squirted into his mouth with no problems with choking.

If you think your parent is undermedicated or has other issues, maybe your hospice nurse and you can come up with a plan for some better management.

[seaofclouds21, BSN, RN]

My grandmother was recently home with hospice (she passed in September). Her hospice team was wonderful and had many medications available for us to get her sublingual, so that she didn't have to swallow pills. I did ask them about IV medications and they usually do not use IV's because of the pain aspect of sticking the patient for new IVs if they loose their access (and they don't want to be without a way to give the patient the medication). In their in-patient facility, they used sub-cutaneous lines to give Morphine, Ativan, etc rather than IV lines because it was easier to start and maintain those lines.

Definitely talk to your parent's Hospice team about the options to ensure that your parent is being kept comfortable at all times. As far as the legal/ethical/moral issues, it may vary state by state, but I have seen patients at home use IV medications before, so I doubt it's illegal. As long as you were following the same practice you would for any other nurse/patient situation, I think it is most likely okay.