hospice care and Pt depression

[caringRNne]

Just wanted some imput from those who work with hospice and home care pts. I am a RN (recent grad). My husband and I just returned home from visiting his grandfather who has lung cancer. They have done all the treatments they can. We have reached the point enough is enough. The treatment being worse than the disease some days! My question is his grandmother continues to ask the hospice nurse about a medication for depression, and the nurse seems to tell her he is already on too many meds. The doc has been asked a few times but still nothing. On our short visit I could tell he was in need of an antidepressant. My classes in school always taught a terminal illness like Cancer the pt should be given an antidepressant. I was wondering what other nurses where taught??? I hope if I am ever terminal they give me one cause I am sure I would be depressed!! Thanks

[NRSKarenRN, BSN, RN]

When i worked Hospice, antidepressents were used frequently for both depression AND as adjunctant to pain meds. Ask to have the Social worker perform depression screening and if no help, talk with Hospice Nursing Supervisor. There are many more useful meds nowadays with minimal sedative effect. Concern might be that if med is used for depression might not be covered under hospice program benefit.

Hospice should be about CARING. Your grandfather is lucky to have you as an advocate. Keep advocating for him...go up the chain of command if need be to Medical Director.

Good luck, let us know how things turn out.