In hospice care, bodily functions start to fade, which might increase the effects of medical substances on the body. As the body becomes weaker, it can no longer effectively compensate for the adverse effects of medication, making frail patients increasingly susceptible to adverse effects.
Simplifying medication
As death draws closer, the patient’s medication regimen becomes increasingly simplified and ultimately focuses solely on symptom relief. The objective is to ensure that the patient is as comfortable and pain-free as possible. However, changes to medications should only be made after talking to a doctor, who reviews the medication and makes adjustments based on discussions with the patient.
The impact of life expectancy on medication
The patient’s medication needs depend on their estimated life expectancy. There may be medications that the patient has taken for a long time that were previously considered to have beneficial health-promoting effects for the years to come. As the patient’s life expectancy is now measured in months or weeks, the necessity of such medications (such as medications for cholesterol, osteoporosis, and some other medications taken to prevent diseases) should be reevaluated.
In the case of some medications, the patient’s life expectancy may even change the ways in which medicines are used or the objectives of treatment, since potential adverse effects manifesting in the years to come are no longer a concern when treating the illness. For example, when treating diabetes, it’s safer to aim for blood glucose levels slightly above the ideal, in order to avoid dangerously low levels. Heart and blood pressure medication is also often de-escalated, since towards the end of life, the patient’s blood pressure tends to be low rather than high, which increases the risk of falls.
Changes to medications should only be made after talking to a doctor, who reviews the medication based on discussions with the patient.