Long-Term Use of Appetite Stimulants

Specialties Hospice

Published

Hello-

I am so glad that I found this website. I am a registered dietitian working with a hospice organization in Athens, GA. I have been with the organization for a few months and have been doing mostly patient and family educations (high cal, high pro; diet strategies to reduce N/V and constipation, etc). I am trying to become more involved with the organization and thought looking at the use of appetite stimulants (cost effective?) might be a good idea. My question to you is how long should a hospice pt. be on an appetite stimulant? Our appetite stimulant of choice is Megace, however several are on Decardron for mets, and bone pain and receive the added benefit of appetite stimulation. Many of our patients are admitted to hospice on Megace with continued poor po intake and are left on it for months and months. Does anyone have a standard of practice for these meds or just guidelines that you go by for the use and duration. I appreciate all your help.

AT what point are you talking about using Megace? From my humble POV, I wouldn't really use Megace at all. If the patient doesn't want to eat, they don't have to. At EOL, their body is shutting down, right? Why would you do that to them? As for the family, a little teaching about EOL s/sx is what I'd do. :rolleyes: Isn't that what hospice is all about?

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AT what point are you talking about using Megace? From my humble POV, I wouldn't really use Megace at all. If the patient doesn't want to eat, they don't have to. At EOL, their body is shutting down, right? Why would you do that to them? As for the family, a little teaching about EOL s/sx is what I'd do. :rolleyes: Isn't that what hospice is all about?
You are absolutely right. I agree. I try to talk the nurses and MDs out of Megace everytime. It's just that many of our patient are admitted to our hospice already on it and unfortuately some of the nurses have the mind set that anyone admitted with failure to thrive should have an appetite stimulant. From reading the feedback from this list I now have some research to back up my proposition to evaluate the use of appetite stimulants with our patients. You guys have given me the knowledge and support that I needed to try to go forward. Now that Medicare has stopped paying for appetitie stimulants many of our patients are going to be in trouble with the high cost. Thanks for your help.
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You are absolutely right. I agree. I try to talk the nurses and MDs out of Megace everytime. It's just that many of our patient are admitted to our hospice already on it and unfortuately some of the nurses have the mind set that anyone admitted with failure to thrive should have an appetite stimulant. From reading the feedback from this list I now have some research to back up my proposition to evaluate the use of appetite stimulants with our patients. You guys have given me the knowledge and support that I needed to try to go forward. Now that Medicare has stopped paying for appetitie stimulants many of our patients are going to be in trouble with the high cost. Thanks for your help.
If you're looking for info, try HPNA @ www.hnpa.org

:)

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