Compounding for Patients in Hospice Care

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What is Hospice Care?

“Hospice care is a special kind of care that focuses on the quality of life for people who are experiencing an advanced, life-limiting illness and their caregivers. Hospice care provides compassionate care for people in the last phases of incurable disease so that they may live as fully and comfortably as possible.”


Addressing the patient’s physical needs may be the most important issue in hospice care, as maximizing comfort is a major goal. Since a hospice strives to improve the quality of life for patients, it is important to address all symptoms they may experience. 

Some problems that hospice patients experience are:

  • Pain
  • Constipation
  • Nausea and vomiting
  • Anxiety & depression
  • Difficult breathing (dyspnea)
  • Muscle loss and weakness (cachexia)
  • Wounds
  • Terminal restlessness
  • More

Hospice patients are often unable to tolerate many of the conventional medication dosage forms or often need specialized concentrations of medications to adequately resolve their ailments. Compounding pharmacies have the ability to assist with these problems by making medications into patient-specific dosage forms and strengths.

Some unique dosage forms commonly prescribed for hospice patients are:

  • Capsules
  • Sublingual drops
  • Suppositories
  • Oral suspensions
  • Inhalations
  • Sprays
  • Troches
  • Topical/Transdermal gels and creams
  • More

Let’s explore some of the most common ways compounding pharmacies, like Eastern States Compounding Pharmacy, provide more customized approaches to hospice care medications.

Pain management and control is one of the best ways to provide terminally ill patients with the most comfort possible. Many terminally ill patients are restricted from enjoying their last days with friends and family due to their uncontrolled pain. 

Types of pain differ not only in their symptoms and presentations, but also in their response to different classes of pain medications. Hospice prescribers are granted more freedom and creativity in addressing pain in patients with compounding. Customized care plans may call for a transdermal pain cream or gel which may target the area better, while others may be better suited with an oral liquid or nasal spray, etc. 

Medication is not one-size-fits-all and considering every patient’s specific needs, tolerance, body weight, and other factors is what sets compounded options apart.

Many times, a patient that has been placed in Hospice Care is experiencing side effects like vomiting from their condition or their prescription medications. Compounders provide patient-specific options for nausea as needed. Commonly prescribed drugs for nausea include such medications as promethazine, scopolamine, lorazepam, diphenhydramine, haloperidol, metoclopramide, and others.

Many patients that enter a Hospice are unable to be mobile or are limited, and develop bed sores (decubitus ulcers) and other pressure sores that cause skin breakdown and hold potential for worsening into necrotic tissue or other painful conditions.

Medical providers commonly prescribe a combination of medications to assist with pain and soothe the tissue, prevent or address infection, and promote healing. They may include ketoprofen, lidocaine, bupivacaine, misoprostol, metronidazole, phenytoin, or diphenhydramine. Source: PCCA

As the aging population grows, there lies the need for more options in optimizing quality of life during the end-of-life stage. Patients, their families, and their medical practitioners work closely with our expert pharmacists to get the best possible medication or combination of medications to best fit specific circumstances. 

While only a few conditions are explored above, there are many symptoms and conditions that Hospice care patients experience that may be addressed via compounded medications. As experts and pioneers in the compounding pharmacy industry, trust Eastern States Compounding for all of your medication needs.

Eastern States Compounding provides services locally in New Hampshire, and even extends to our neighbors in Maine, Vermont, Massachusetts, Connecticut, Rhode Island, and New York.

Are you a patient or family member of a patient entering Hospice Care? Ask your doctor about options in compounding that best suit the situation. We’re happy to help and consult.

Are you a practicing physician, nurse practitioner, or physician assistant interested in exploring more options in compounding? Connect with us to learn more and get examples of what your colleagues are prescribing.

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