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Blog articles are provided as informational purposes only and are not intended to constitute medical advice. Medication protocols are subject to patient’s medical provider’s authorization.


Anxiety is one of the most common symptoms for hospice patients. It has been reported within 20% to 50% of patients with advanced cancer.  While the impact of anxiety is recognized, anxiety management in palliative care is a major challenge due to a variety of contributing factors.  Timely identification, support, and treatment of anxiety are essential in patients with limited life expectancy.  Anxiety management benefits from a multi-dimensional team approach.  From physicians to nurses to social workers and spiritual care – all disciplines can play a role in helping alleviate anxiety.  There are several etiologies behind anxiety in hospice patients – including metabolic causes, drug withdrawal, and adverse drug effects.  Anxiety has cognitive, emotional, behavioral, and physical manifestations ranging from mild/occasional to a severe/constant state of anxiousness.



The use of antibiotics is an ongoing ethical debate in hospice care as it can be perceived to be less aggressive/invasive than other curative/life-prolonging interventions (e.g., intubation, dialysis, chemotherapy, etc.).  Hospice patients are especially vulnerable to infections and have high rates of resistant bacteria due to long-term chronic illness.  However, there are no guidelines directing appropriate antibiotic decision-making in hospice patients.  Therefore, hospice-related infectious disease studies seek to determine if antibiotics provide symptom relief and/or prolong survival in our patient population.



For healthcare workers, the toll of the COVID-19 pandemic has been indescribable. There have been few health events in modern times that have caught healthcare professionals as unprepared as the novel Coronavirus. There are roughly 28 million nurses working globally, constituting approximately 59% of the health sector and delivering up to 90% of care services. With regard to the hospice population, the strain on nurses is extraordinarily high.


There are currently three categories of dementia treatment medications:

Cholinesterase Inhibitors: donepezil (Aricept®), rivastigmine (Exelon®), galantamine (Razadyne®) – These medications increase levels of acetylcholine, a neurotransmitter in the brain, by preventing the enzyme acetylcholinesterase from breaking it down.

N-Methyl-D-Aspartate (NMDA) Receptor Antagonist: memantine (Namenda®) – Memantine blocks the NMDA type of glutamate receptor during periods of overstimulation.

Anti-Amyloid Monoclonal Antibody: aducanumab (Aduhelm®) – Aducanumab reduces the amyloid beta plaque deposits that occur in Alzheimer’s disease. The FDA granted accelerated approval for this medication on June 7, 2021, with continued approval contingent upon whether post-approval trials verify its clinical benefit. At this time, it is recommended for initiation only in the mild stage of dementia or cognitive impairment.


Pruritus, also known as itching, is not the most common symptom seen in our patients at end of life, but it can be distressing and adversely affect quality of life. Pruritus can be described as an unpleasant sensation of the skin or mucous membranes that provokes the desire to scratch or rub. There are several chemical mediators, known as “pruritogens,” that are involved in the pathophysiology of itching. Although histamine is the best known pruritogen, there are several others, including serotonin, cytokines and opioids, that can play a role. This helps explain why not all itching sensations respond to treatment with antihistamines.


ANCC Accreditation

ProCare HospiceCare is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation.