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About Christine Johnson
Expertise
I can give suggestions, encouragement and direction on what hospice is and is not, when it is appropriate, and how to go about getting it. I am familiar with Medicaid and Medicare hospice benefits. I can answer general questions about disease process, what dying looks like, how hospice handles pain and other symptoms, what to expect from a hospice when end of life nears. I can provide support, direction and encouragement related to spiritual matters and psychological matters related to death and dying.

Experience
I am a certified hospice and palliative care nurse, and have been the director of nurses for three hospice centers, under two different companies. I have also worked as a contract hospice nurse for a large American hospice company. On a personal level, my father died without benefit of hospice (it was not popular then). I have taken care of dying patients in hospitals and recognize that for most of us, it is preferable to die at home (or in our residence, wherever that may be), comfortably and without anxiety. Also I had no support when my father died; hospice clients are the whole family (however that is defined by the "patient"), and support is provided at least a year after the patient passes. These are the sorts of things (and probably others) that I can help with.

Organizations
HPNA (Hospice and Palliative Nurses Association)

Publications
none yet

Education/Credentials
Registered Nurse (TX), Licensed Marriage and Family Therapist (TX) ADN Nursing, Excelsior College, Albany, New York (2004) 4.0 GPA BA, Psychology (minor Social Work), Oklahoma University, Norman, OK (1986) 3.67 GPA MHR (MA) Human Relations, Oklahoma University, Norman, OK (1988) 3.5 GPA

Awards and Honors
Phi Beta Kappa (and others)

Past/Present Clients
Unable to name as this would violate their privacy (and HIPAA....)

You are here: Experts > Health/Fitness > Death and Dying > Hospice Care > Medications

Hospice Care - Medications

Expert: Christine Johnson - 11/6/2009

Question
Have a friend who's mother is in congestive heart failure. She is being placed into a Hospice facility. My friend is concerned that if you choose hospice the only medication the patient receives is for pain. If they choose hospice, will hospice continue her regular medications and the drip she is now on?? When the hospital tried to remove the drip she started breathing heavy and panics which causes her not to be able to catch her breath. Her main concern is if they choose hospice are they able to give the patients there medicines??

Answer
The only thing about hospice medications is that they won't be going for "cure." Your friend's mom is in congestive heart failure. There is only so much meds can do. If the meds she is on currently make her feel better, then there is no reason whatsoever for them to be discontinued.

In addition, she should make sure that antianxiety medications (aka anxiolytics, literally "anxiety cutters") are included in the plan. Examples are ativan, xanax, valium--these all make people who cannot catch their breath kind of chill out and not mind. They only make the process more pleasant. They won't speed or delay passing.

Hospice medications include those which manage a patient's symptoms, whatever they may be. Pain is just part of it. Some patients produce a lot of secretions and feel like they are choking or drowning; there is medication to dry those up a bit. Some feel pain, there are pain meds. Some feel nausea, or get constipated or have diarrhea, and the meds for those things are included in hospice meds.

Hospice is a philosophy, and I can tell you how that patient would be cared for if she were my patient. But not all hospices are created equal. Your friend--and maybe you also--should take part in the admissions process, and these specific questions should be addressed. Specific answers should be forthcoming. If not, then I strongly suggest you talk to the director, and get specifics. If you are not satisfied and do not feel secure, don't assume all will be well anyway. There is still a bit of time, continue your search for appropriate hospice care. It maybe be that your friend's Mom finishes her days on earth while staying in her daughter's home, being cared for by family and friends and friends of family.

You'll be surprised how fast you get the answers you need if they know (in a very nice way, of course) that you want and expect the kinds of specifics about the care this lovely lady will receive. Your friend and her Mom deserve at least that.

I hope this has been helpful, please write again if I can answer other questions.

Warmly,
Christine

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