Posted on 10/27/2025 8:36:43 PM PDT by ConservativeMind
Hospice care aims to bring comfort, peace, and dignity to patients at the end of life. Yet for the growing number of Americans with dementia who enter hospice, their course is often long and unpredictable—making it especially important to ensure treatments align with each person's goals and stage of illness.
A new study published finds that medications commonly prescribed to ease symptoms such as agitation, anxiety, and delirium—benzodiazepines and antipsychotics—may carry major unintended risks for people with dementia receiving hospice care.
Among more than 139,000 nursing home residents with Alzheimer's disease and related dementias enrolled in hospice between 2014 and 2018, those who began taking a benzodiazepine or an antipsychotic after enrollment were 41% and 16% more likely to die within six months, respectively, than very similar hospice patients with dementia who did not receive these medications.
"Dementia is now the most common qualifying condition among hospice enrollees, yet many patients are not imminently dying," said Lauren B. Gerlach, DO, MS. "Because prognosis in dementia is so difficult to determine, nearly 1 in 5 patients will outlive the six-month eligibility window for hospice. This makes it critical that medications used during this period enhance, rather than diminish, quality of life."
The study analyzed national Medicare data from a rare period when hospices were required to report prescribing information.
None of the patients studied had received the benzodiazepines or antipsychotics in the six months before entering hospice.
Despite this, nearly half (48%) received a new benzodiazepine prescription and 13% received an antipsychotic after hospice enrollment—most within the first few days of admission. The average hospice stay was more than 130 days, indicating that most patients were not in the final weeks of life. Benzodiazepines include medications such as Ativan and Valium, while antipsychotics include medications such as Haldol and Zyprexa.
(Excerpt) Read more at medicalxpress.com ...
Of note: “Large and for-profit agencies were significantly more likely to prescribe these medications.”
It seems they have a profit motive to provide extra drugs that can kill.
My wife was in hospice care after 5 years and 10 months fighting stage-4 cancer. I saw first hand what hospice nurses and workers did. It was way better than I expected. It was outstanding! I am forever grateful for the help received from hospice. I know each hospice is run differently. We were fortunate.
In the handful of times my family or acquaintances used hospice services they were uniformly impressed.
yes. most people with dementia don’t belong in hospice. old age isn’t an immanent death situation. they are probably being warehoused by relatives who don’t want to take care of them. the ‘bad’ hospice ‘care’ places are probably doing what they can to maximize profit. sad.
Does it matter when it comes to dementia? Hospice is to provide comfort at the end. If these drugs do that, but with the possibility of shorting life, so what!
No. After years of family lovingly caring for dementia patient they enter a stage where family can no longer care for them. If you don’t know what you are talking about then STFU!!
i know exactly what i’m talking about. having taken care of my mother with dementia for 5 years now.
Sorry. Lost it. Dementia is not just not knowing where your keys are. The stages get progressively worse. The end stage they can not swallow or walk or talk. It is a horrific disease not only for the victim but their loved ones also. When you say “They are probably being warehoused by relatives who don’t want to take care of them” it just made me so mad.
the truth hurts. but, what i’ve seen, i’ve seen.
My MIL is in next to final stage. 4 years ago she would do every one’s taxes. Now she doesn’t even know who we are. She has hallucinations. My wife has to change her diapers and bath her. She can only mutter a few coherent words. I can see the effects stress has on my wife, FIL and sister in law. They refuse to put her in a care home. I just keep hoping she passes peacefully in her sleep.
may God continue to bless you and your MIL. it’s wonderful that she has a faithful, caring family to help her through to the end (or as near to the end as you can make it). i tell you, your reward in heaven will be great.
there’s no question that you have to fight like hell for your dementia patient. we’ve cared now for two. one has passed on. many times our moms would have been taken from us early, but for our diligence with medical authority and even our own ignorance. they know nothing really about dementia, despite wasting untold millions on research (that’s what ought to make you mad). may God keep you and yours strong.
Thanks and sorry about your mom. You are so right about the money squandered on research. It shouldn’t be so hard to come up with effective treatments. There has got to be a lot of corruption going on. Just look at the state of our Universities.
My personal choice would be to be allowed to die. There is no use being kept alive when no longer able to take care of myself or recognize anyone.
My wifes Mom lived with us until we put her in Elder care then Hospice. The rapid rate of decline shocked her, but not me. She lived on a diet of Ensure and air for 8 years. In the summer, she would sit outside and drink the only food she ate about 12 a day. By the time she went into care, my wife was fighting Cancer for 4 months, completely spent. When Bettie passed, I was the only one near her, I had sent my wife to see her friends 100 miles away. It was a total blessing for her. Sandy, my wife is now cancer free and approaching 66 years. Her Mom Betty, lived 95. I hate Hospice and end of life, but without it we may have had 2 deaths. God bless these people that do this.
You are correct, We..husband and wife... did 8 years, and it was lousy at the end. Thank God for Hospice. Grandma wouldn’t even allow us to get her hair cut, showers were bi monthly events. Though in dementia, she could walk talk and play solitaire. We did what we could, and then put her in Hospice for the last month. You take care of family, it is what you do.
> It seems they have a profit motive to provide extra drugs that can kill.<
You have it backwards. Hospice is used for end of life care. The end is near.
The money made by using these drugs pales in comparison to the $7500 monthly out of pocket cost to be in hospice care. If profit was the motive, they would do everything possible to extend life, not end it.
It takes a special type of person to work in hospice. Providing care and comfort to the dying should earn them a special place in heaven.
EC
Like the hospital care for COVID a few years back.
COPD was the culprit that caused his inability to to breathe.
COPD was the end result of 55 years of cigarette smoking.
Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.