Hospice will not take MIL due to cancer drug. Now what to do?

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dllynn Asked April 2014

Hospice will not take MIL due to cancer drug. Now what to do?

My MIL was diagnosed with breast cancer 2.5 years ago, age 93 and we opted for no surgery but she is on a drug to shrink the tumor and just keep it at bay. She has now had two strokes, an infection sent her to the hopsital in Sept, came out and was on hospice until Jan because she improved. Well she has had another infection and a fall in the last two weeks, she has declined to the point where we are trying to bring hospice in again. We had a very good meeting with them but during that meeting we found out that due to new rules, they can not take her due to the drug. They offered many suggestions and one is to stop the cancer drug? We are using the drug as pallative care and not to cure. We are not battling in our minds what to do? We are working with her primary care Dr and the oncologist. But still what would you do?

End of Life

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score 0 · Answer 1

I wonder, are ALL hospice agencies created equal? There are more out there to ask and see what they say. But if this drug is causing the infections & falling, I vote to take her off it and leave her alone.

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score 0 · Answer 2

I would stop the drug.Have the Dr giver her another type of drug if any.

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score 0 · Answer 3

My personal inclination would be take her off the med, get her in hospice, they will be able to provide comfort in case there is pain due to the tumor or anything else. This will allow her to live / leave in peace.

However, I would put my intellectual decision aside and I would honor her perspective, is she ready to go?

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score 0 · Answer 4

Many chemotherapeutic agents are not good for immunity.. Is it possible the drug she is taking accounts for the increased rate of infection? If it is one of those, I would stop it. There are always trade-offs, unfortunately.

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score 2 · Answer 5

If the drug is to shrink a tumor, it isn't medically considered palliative care. This is why hospice cannot get involved...they are a last resort for only palliative care. This may be due to the way that the FDA classifies the drug. Your doctor may have prescribed it as palliative care out of compassion, but if the drug classification does not include palliative care, hospice cannot consider it palliative care. I think you are between a rock and a hard place here. From what you describe in your mother in law, the tumor isn't going to be what ends her life, its likely not going to grow fast enough to make her uncomfortable. It sounds like strokes and infection are far more a concern. You may be better off stopping the drug, and moving to pain management with hospice care.

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score 0 · Answer 6

What is the likely consequence of stopping the drug? Will she be in pain? Sleepy? What symptoms are likely to appear?

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Hospice will not take MIL due to cancer drug. Now what to do?

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