Each individual is unique and therefore requires distinct medications to provide the necessary comfort at the end of life. However there are a few more commonly used medications administered during ones transition.
Medication is a vital part of end of life care. It gives relief to the most common end of life symptoms. These symptoms include, shortness of breath, anxiety, nausea and pain, along with others. Medications that can ease these discomforts enables the patient to have a better quality of their remaining time.
The Care/Comfort Package provides the immediate use of the medications in an attempt to avoid any lapses of the control of various symptoms which gives comfort to the patient. Below is a list of the most common end of life medication provided in the hospice care/comfort kit as referenced in the article: Common End of Life Medication: the Hospice Comfort Kit; American Family Physician website; https://www.aafp.org/pubs/afp/issues/2017/0315/p356.html
- Haloperidol or Risperidone – effective in treating delirium
- Acetaminophen – fever
- Lorazepam – anxiety
- Morphine – pain
- Hyoscyamine – excessive oropharyngeal secretions (death rattle)
The most contradictory medication commonly included in the comfort/care package is morphine. Many people consider morphine as a liquefied grim reaper. Morphine is an opiate, a narcotic that is addictive and even deadly if not used properly as prescribed by a physician. The word ‘narcotic’ is frightening in of itself, combining that word with end of life is even more terrifying.
However, morphine can eliminate the severe pain that can be experienced at the end of one’s life. It can also reduce the effect of air hunger (dyspnea) which can also be encountered by patients at the end of life and is extremely frightening for everyone. It also gives the caregiver peace of mind that your loved one isn’t suffering.
In most cases, when the use of morphine is prescribed for an end of life situation, the concern of addiction is removed since the life expectancy is 6 months or less. However, one should still be aware of the dangers of possible overdose causing death. The goal of morphine use is to give comfort and pain free existence for the patient. The dose of morphine can, and usually is, increased to help manage the end of life pain. Even though the increase should only be given with the prior consent from a physician, it can be scary for the caregivers administering it. If ever in doubt the caregiver should contact the hospice team for advice.
Again, it is not the morphine that kills at the end of life, it is the illness that kills.
Any and all medication should be administered as prescribed by a doctor. As usual, any and all unused prescribed medication should be properly disposed of. The hospice team can assist with this.
I am not an expert or medical professional. All the information included was found on on-line searches. Any questions or concerns should be addressed with a physician or other medical professional.
Does the word ‘narcotic’ frighten you? Please share your thoughts.
Best wishes
