How the Medications in a Hospice Comfort Kit Can Help

Hospice comfort kits contain prescribed medications used to treat end-of-life symptoms, such as pain, anxiety, nausea, and shortness of breath. Many kits come with medications for reducing mucus production and the "death rattle" of wet breathing sounds that mucus buildup causes. Hospice comfort kits can also be tailored to a loved one's specific needs.

This article explains the types of medications that are typically prescribed in hospice comfort kits, along with how they can help a person in their last phase of life.

What Is a Hospice Care Kit?

The hospice comfort kit—also known as the emergency kit, e-kit, or hospice kit—is a prescribed set of medications that are kept in a patient's home should a medical crisis strike. Having the medications already in your home will help the hospice team treat any distressing symptoms as quickly as possible.

The hospice comfort kit may be ordered and delivered to your home at the start of hospice care, or anytime the case manager nurse sees a possible need for one. The actual contents of the kit vary. In some cases, it may be custom-designed for the diagnosis, but this will vary widely among hospice agencies.

Medications that may be found in a hospice comfort kit and the symptoms they might treat include:

• Morphine Liquid: Used to treat pain and shortness of breath
• Ativan (Lorazepam): Can be used to treat anxiety, nausea, or insomnia
• Atropine drops: Used to treat wet respirations, also known as the death rattle
• Levsin: An anticholinergic like atropine, also used to treat wet respirations
• Haldol (Haloperidol): Can treat agitation and terminal restlessness
• Compazine (Prochlorperazine): In either pill or rectal suppository form, this medication is used to treat nausea and vomiting
• Phenergan (Promethazine): An anti-emetic like Compazine, Phenergan is used to treat nausea and vomiting
• Dulcolax suppositories (Bisacodyl): Rectal suppositories to treat constipation
• Senna: A plant-based laxative used to treat constipation
• Fleet enema: Used to treat constipation if other treatments are ineffective

Other medications may be included depending on the hospice diagnosis. For example, a patient with a brain tumor who is at risk for seizures may have valium suppositories included in their comfort kit.

How Hospice Comfort Kit Medications Can Help

Hospice comfort kits are designed to provide rapid relief from symptoms that may be experienced in the final weeks or days of life. True to their name, hospice comfort kits are meant to maximize a dying person's comfort and dignity, and, in doing so, bring comfort to their loved ones.

End-of-life symptoms that hospice comfort kits can help with include:

• Pain: Hospice comfort kits contain strong pain relievers like morphine. They can be used to stop pain rapidly, helping a person rest comfortably.
• Anxiety: Many people experience bouts of fear and worry in their final stages of life. Medications like lorazepam quickly quell anxiety and improve wellbeing.
• Nausea: Anti-nausea medications like Haldol work rapidly to lessen feelings of sickness that are often experienced at the end of life.
• Shortness of breath: Liquid morphine can be given to alleviate breathlessness. This will help relieve fear and restore calm.
• Death rattle: Although the death rattle is not painful for the person experiencing it, it can be distressing for loved ones in the room. Drugs that reduce mucus production can help relieve this distress.

The medications inside of a hospice comfort kit are prescribed by a hospice physician, who can add or remove medications to the kit depending on your loved one's needs.

How to Use Your Hospice Comfort Kit

Your hospice nurse should explain each medication to you, including the purpose and correct way to administer it.

Some hospice agencies simply instruct their patients not to use any of the medications and then wait for a symptom to occur before explaining the medication. However, this method of instruction has a major drawback because it requires the patient or caregiver to learn about a new medication under a great deal of stress, which is difficult to do.

If this is how your hospice agency instructed you, consider asking your case manager or nurse to explain each medication to you before any symptoms occur. That way you can be prepared if and when symptoms appear.

Summary

Hospice comfort kits contain prescribed medications that treat common end-of-life symptoms like anxiety, pain, and nausea. The medications are intended to quell distressing symptoms rapidly, allowing a person to feel calm and comfortable as they approach death.

Hospice care nurses are responsible for explaining how to use the prescribed medications properly along with when to use them. If you have any questions or concerns about using a hospice comfort kit, don't hesitate to reach out to a hospice nurse or case manager for assistance.