LO on hospice for CHF. LO also has dementia, COPD, seizure disorder, diabetes. Takes 3 blood pressure meds. Hospice says it is up to the family to take them off of any meds. When they take lo blood pressure it's still a little high and when it gets lower they will take off blood pressure meds. Lo can still walk to toilet but very unsteady. I think blood pressure is low when they get up. Any advice on hospice and blood pressure meds. Very difficult to know what to do. I thought hospice took away meds. Very confused. I am very thankful for hospice. Is it totally our call about meds
A medication like Aricept, Namenda, Cholesterol medications are generally discontinued.
So the Hospice Nurse is right it is your call to continue or discontinue some medications.
I would say if discontinuing a medication would "hasten" death or make the person uncomfortable if the medication was stopped then you continue it.
(If stopping a blood pressure medication would lead to headaches, unsteady gait, possible fainting then it is more of a risk removing the medication so you continue it.)
The problem so often for hospice is that when they recommend "stopping all drugs" the family comes back at them as though they are trying to KILL their client. The truth is that hospice is "end of life care". To be perfectly blunt, the goal here is death. It is expected, it is prognosed by medical team, it is "sought" if you will, with minimal side effects. It is comfort care.
You are perfectly free, as family, to give the blood pressure meds if you wish to, as they were recommended by doctor, but if you are doing this and still attempting to get loved one up to bathroom, and are experiencing postural hypotension with position changes, it is dangerous. Being primarily on bedrest it is unlikely that up BP will cause problems, but LOW bp may. Measure the BP if you wish, and give meds as you choose. As I said, the meds are unlikely to make the difference UNLESS they result in a fall.
Discuss this again with Hospice and ask for their recommendation. If the nurse cannot answer your query then ask to speak with their MD.
Blood pressure does go down after a bowel movement. It did with my Mom. You can't take a person off of Blood pressure medicine its a lifetime thing usually. Their numbers are good because they are on meds. If your talking her Blood pressure becomes too low, maybe you need to get rid of some of the meds. Three sounds a lot. Maybe Mom needs an adjustment in the amt of mgs she is taking daily. My Mom took 86 mgs a day. Went to the hospital in pain. B/P goes up when in pain. They doubled Moms dosage and discharge papers showed the doubled dose. My Mom could not get off the couch because her b/p was extremely low and was no longer in pain. Called her PCP and he took it back to 86mg and she went back to normal. Call her PCP and see if some of the meds can be discontinued or even lowered.
If it were my loved one and their blood pressure was still reading high, I would most certainly keep them on the blood pressure medicine until their blood pressure normalizes and perhaps allow them to sit at the edge of the bed before getting up to walk if you believe that their blood pressure is dropping shortly before getting up.
And please don't allow hospice to take your loved one off of their seizure medications, as that is so very dangerous for your loved one.
My late husband who also suffered with seizures while on hospice took his seizure medications right up until he went into his "active" dying stage which lasted 41 days, and he ended up having seizure after seizure even with the liquid medication hospice provided to try and help.
So don't forget, you and you family are in charge of what hospice does or doesn't do for your loved one, so don't be afraid to stand up for what you believe is right.
Good luck with a difficult situation.