When a patient has a terminal illness and is expected to live 6 months or less, they can receive hospice care. A team of providers, including a pharmacist, works to help the patient be as comfortable and free from painful symptoms as possible. Home healthcare, including pharmacy services, are available for hospice patients at home And typically covered by Medicare, Medicaid, and most insurance plans. Learn more about hospice pharmacy services.
When a patient usually has a life expectancy of less than 6 months, their doctor may recommend them for hospice care. Hospice means that the patient no longer seeks a cure but instead wants to be treated for pain relief and other symptoms. Hospice provides these patients a combined set of services including medical care, emotional and spiritual support, and pharmacy services and can be provided in different settings such as:
- The patient’s or a family member’s home
- An independent hospice space that may offer inpatient hospice care
- A hospice program available through many hospitals
- Long-term care or assisted living facility with a hospice unit
Hospice pharmacy services are provided by trained pharmacists and include medication therapy management (MTM) and emotional care for patients in hospice. A hospice pharmacist does many of the same things as a regular pharmacist, such as:
- Talking to patients about their medicines and how they are working
- Learning about which medicines can have bad interactions with each other
- Making sure patients get the dose of medicine prescribed by their doctor
Hospice pharmacists provide these services and also manage the special challenges that can come with end–of-life care. These include complicated MTM, the need for more consultation with patients, and an understanding of end-of-life care.
Even though the point of hospice isn’t to cure conditions, medicine is still very important for helping patients manage their pain and other symptoms. The more medicines someone takes, the higher the risk that they will have an allergic reaction or a bad response to a single medicine or between different medicines.
Hospice pharmacists are aware of these interactions and can work with the patient’s doctors to find the dose, delivery method, or version of the medicine that will work best for the patient.
In addition to consulting with patients about side effects and how a medicine is working, hospice pharmacists also can talk to patients about how often they are taking their prescribed medicine and the reasons why they might not be taking these medicines as prescribed. Reasons can include:
- Side effects. If a medicine causes too many side effects or an allergic reaction, patients might decide not to take that medicine.
- Stigma. Some patients are worried about becoming dependent on the medicines they need to take, especially pain medicines like opioids.
- Cost. Hospice care is usually covered by Medicare, but some patients still might not be able to afford all of the medicines they take.
Hospice pharmacists can consider all of these factors and decide if there are other medicines or alternative doses of a medicine that will address the patient’s concerns.
End-of-life care can require a different perspective than a normal pharmacist who is focused on treating and curing illnesses. Hospice pharmacists are aware of the emotional stress of the dying process for the patient, their family, and their caretakers
Medicine is often used to help with pain management. The hospice team may use over-the-counter medicines, like ibuprofen, or stronger pain medicines, including opioids like morphine. Talk to your doctor or hospice team at any time about what’s working or not working. They can quickly change treatment plans or medicines and will do everything they can to make the patient comfortable. Your pharmacist can answer many questions about these medicines and any side effects.
Most insurance plans, including Medicare and Medicaid, pay for hospice pharmacy services, including home pharmacy services and palliative care. If you have financial concerns or need help navigating the healthcare system, talk to your hospice team.