The COVID-19 pandemic has put our medical system in uncharted waters, but much of what we know as hospice clinicians may be applicable in some cases. It’s also worth noting that we were in the midst of a relatively serious flu season prior to the novel coronavirus emerging. That’s why this month’s installment of Palliative Pearls features several cases from our archive relating to respiratory therapy, as well as a primer on vaccinations in hospice and a review of rectal administration as preferred forms of some medications become harder to obtain. We hope these materials will be useful for clinicians regardless of whether they treat patients with COVID-19.
Underlying Causes & Management of Cough
At end of life, lack of energy, muscle weakness, failed attempts to expectorate sputum and the inability to coordinate an effective swallow result in ineffective, persistent coughing. RH, a patient with colon cancer, asthma and glaucoma, needs relief for his cough. How should he be treated? Read more.
COPD Inhalation Therapy Conversion
JA is a 75-year-old woman who was recently admitted to hospice with a primary diagnosis of COPD with comorbidities of rheumatoid arthritis and dementia. JA reports worsening shortness of breath despite taking all her medications as directed. Could her comorbidities require a change in medication regimen? Read more.
Inhaled Therapy Case: Selecting the Best Device & Mixing Nebs
DP is a 72-year-old female with a primary diagnosis of COPD and multiple comorbidities. She has been using guaifenesin syrup around the clock for increased cough and congestion without relief. DP’s physician is considering replacing sodium chloride with acetylcysteine via the nebulizer. How can you ensure that DP is effectively administering her respiratory therapies? Read more.
Vaccination Considerations at End of Life
Patients receiving hospice care are at considerably high risk for serious complications if they contract a vaccine-preventable disease. What vaccines can be billed to Medicare in hospice? In what circumstances are they recommended? When should they be avoided? Read more.
Rectal Administration and The Macy Catheter ®
JK has a strong desire to remain at home and refused inpatient care in the past when his symptoms worsened. He has periods of unconsciousness, rendering him unable to swallow routine liquid medications. How can rectal administration via Macy Catheter help? Read more.
Enclara clinicians are actively working to develop pharmacological guidance specific to COVID-19. Make sure you get the latest information by signing up for our monthly Palliative Pearls newsletter. The newsletter features case studies, clinical alerts and general hospice news.