Why Does Hospice Encourage Stopping Many Medications?

Increasingly, studies suggest that seniors take too many drugs—those admitted to a nursing home or rehab take on average 15 medications—leading to a worse quality of life and survival. For example, a study in 2007 compared similar groups of patients with terminal diseases and found that the hospice group lived an average of 29 days longer than the group not in hospice.  There are likely several reasons for this improved longevity.

 

Taking a handful of pills not only increases the risk of side-effects, but is often considered a ‘burden’ and stopping ‘non-comfort’ or ‘preventive drugs’ reduces that burden.  Because hospice focuses on comfort—by controlling pain, shortness of breath, nausea—you feel better, and if you feel better you are more likely to sleep and eat better, and to socialize more. 

Newer evidence suggests older seniors don’t need their blood sugar or their blood pressure as tightly controlled as when they were younger.  They feel better with sugars between 150 and 250, and systolic blood pressures [the top number of the BP reading] between 130 and 160:   they are less likely to feel faint, have more energy, etc.  With more common sense goals such as these, people can often reduce or even stop many drugs [as long as they are being monitored by the hospice team].

Examples of other drugs that might be eliminated:  vitamins/minerals, strong antacids, cholesterol-reducing statins, blood thinners such as clopidogrel [Plavix]—essentially anything when the benefits of the drug are outweighed by the risks.

Hospice’s purpose is to help people live comfortably as long as possible—not just to keep them alive.  [a philosophy that anyone can adopt at any time!]