Any experience with "deprescribing" as part of hospice care?

The first thing hospice asked me about was discontinuing unnecessary supplements, and I agreed. Once end of life approaches, only comfort care is required....everything else is superfluous. The last thing I had in mind was trying to extend moms life, at 95, with advanced dementia. Do as you wish but ask yourself what purpose these supplements serve?

My husband took a lot of medication, but when he went on hospice I had no problem with discontinuing supplements and things like his statin, which was no longer necessary. Unless something had an immediate benefit such as his sleeping/anxiety or BP meds, he didn’t really need it. I will add that his life expectancy was short because he was declining quickly and chose to discontinue dialysis a week later, but we would still have stopped a lot of medications just to make life easier. If your mom requests her supplements and it comforts her, I would say keep going with them, otherwise I wouldn’t.

Just remember that your mom or whoever is her POA has the final say as to what hospice can remove and what they can't when it comes to any medications or supplements.
I personally see no harm in allowing her to take her aspirin, daily vitamin and her vitamin C with iron, while she's under hospice care.
My late husband was under hospice care for the last 22 months of his life and he took a butt load of medications for various reasons(mostly for his seizures), and there were several times when hospice tried to get me to discontinue some of his medications. Most of the time I didn't agree with them and he remained on them. The only time I agreed was when it was his cholesterol medicine. He also took a 81 mg aspirin and multi-vitamin right up to the start of his dying process.
So don't forget, just because hospice "recommends" something, it doesn't mean that you have to go along with it.
You do what you feel is best for your mother.

Gees I would think your mom could continue her supplements. I used Hospice at the end with My brother who had stage 4 cancer and Knew the cancer had spread to the brain and consulted with the head doctor at Dana faber and a well Known Psychiatrist and had a wonderful social worker so we Knew it was time . Hospice didnt actually do much My brother was in a good nursing Home . Trust your instincts and go with your gut .

My MIL was on a few medications that Medicare considers treatments to improve health, such as Metformin and statins, also some supplements, that were discontinued pretty much immediately when she went on Hospice. That still left quite a few that were to keep her comfortable; pain relief and anti-anxiety and the like. The main issue in your case, I think, is that Medicare won't cover the cost of these things. However, the actual care will be in your hands and they won't know if she wants to take supplements and pays for them. If she's at the point of hospice, there is probably not much value to these things and as she declines further, she may not want to bother. But I don't believe they would stop her from taking them.

I have never been asked to take DH aunt off of anything and she has been on hospice for several years now. I’m not trying to see her out or keep her here. I just want her to be comfortable.

Vitamins are basically food, and the baby aspirin helps relieve pain. They’re both comfort items, which is the whole point of hospice.

I want to thank everyone for taking the time to respond, share your experiences and thoughts, both for and against. It's been valuable. Thank you!

When my mom began hospice they told us that she would only be taking drugs that were absolutely necessary.

Hospice focuses on comfort care rather than prevention.

My mother wasn’t interested in prolonging her life. She didn’t fear death and was ready to die.

Anytime hospice suggested removing meds that were no longer necessary, we agreed. If they added meds to keep her comfortable such as morphine, we agreed to it.

Wishing you peace as you continue on your caregiving journey.

She is on end of life care.
I cannot imagine why either giving or withholding would make the slightest difference.
I am very surprised that anyone in a Hospice situation would suggest that the goal is "improved health outcome" because the REAL goal for hospice is/should be comfort care for end of life process.

I have never heard the word before "deprescribing", so that's a new one on this RN, but time has marched on since my retirement. Looking it up I found the following online:
https://www.aafp.org/pubs/afp/issues/2019/0101/p7.html
It says that deprescribing is exactly what you just said it is. But as I said, I don't get it.
And to be honest, in end of life Hospice situation I cannot imagine what difference it makes whether she takes the meds you mentioned or not. I doubt an ASA or vitamin is prolonging her life, or making it more uncomfortable, or improving it EITHER.

I would ask specifics:
What medication do you wish to withdraw?
What HARM do you believe this medication is doing?
What is your GOAL in removing this medication?

For me, removing the ASA makes her a bit more prone to stroke, but the ASA itself makes her more prone to a bleed anywhere.
I cannot see what good or harm a medication is doing other than that iron in a vitamin may be constipating.

I just don't get it. So I would ask questions.