Hospice care is built around comfort — and for many people, medication plays a crucial role.
This is where a hospice pharmacist comes in. Hospice pharmacists work closely with physicians and nurses to recommend medications, and with patients and families as another source of information and support.
“Some patients and families feel hopeless, like nothing will work. We can come in and say, ‘We haven’t tried everything — there are more options than you realize,’” says HopeHealth clinical pharmacist Shannon Levesque, PharmD. “We can find a way to get you more comfortable.”
> Learn more about hospice care
1. Helping with complex medical situations
In any healthcare setting, medication decisions require nuance and experience. In hospice, that’s especially true — as many patients live with multiple conditions and shifting symptoms.
When things get complicated, nurses and physicians often consult with the hospice pharmacist.
“For example, if someone has kidney or liver problems, medication choices change,” says Shannon. “We’re always here to help with those complex and challenging cases.”
2. Tailoring treatment to patient goals
Comfort means different things to different people. It’s often about quieting physical sensations like pain, nausea or shortness of breath. It can also be about easing mental discomfort, like anxiety. And when medications are involved, comfort often means striking a thoughtful balance between benefits and side effects, such as sleepiness.
Hospice pharmacists help teams and patients find that right balance, tailoring medications to each patient’s personal goals.
“Some patients want complete relief, while others are willing to tolerate more discomfort so they can stay awake,” says Shannon. “It’s really about figuring out what’s important to the patient and helping make that happen.”
> Read: What’s the difference between hospice & palliative care?
3. Setting expectations & easing fears
A major part of Shannon’s role is education: helping clinicians, patients and families understand how medications work and what to expect.
“I reassure people: this is what’s going to happen, this is how long it will take, this is what to expect,” she says.
She’s also an extra resource for addressing common fears — including the myth that certain hospice medications hasten death.
“It’s the disease that leads to death, not the medicines,” she’ll explain to patients and families. “The medications are there to manage symptoms.”
> Read: Clearing up myths about end-of-life symptom relief
4. Simplifying medications to focus on comfort
By the time a person is in their final chapter of life, many medications — such as statins for high cholesterol — are no longer necessary. As the body changes, they can even contribute to discomfort.
“Some medicines were meant to work over five, 10, even 50 years — and they did what they were supposed to do. They got you here. But at this point, they might actually be causing more side effects than benefit,” Shannon will tell patients. “If you’re not eating or drinking and you’re still taking all of those medications, it can be a lot on your body.”
With that in mind, hospice pharmacists advise care teams and patients on how to simplify medication routines.
“What are the things that are really keeping you comfortable and meeting your goals?” Shannon asks. “Let’s keep those — and get rid of the rest.”
5. Suggesting other approaches
Every person’s body and health situation is unique, which can affect how well any given medicine works. In other words, even commonly used medications aren’t one-size-fits-all.
When one medication approach isn’t bringing as much comfort as hoped, hospice pharmacists help care teams think through safe and effective alternatives.
“If patients have barriers to standard treatments, like difficulty swallowing medications or multiple diseases that cloud decision-making, that’s when the hospice team consults the pharmacist to determine the best options,” Shannon says.
That collaboration is one of the things she values most about HopeHealth.
“Everyone’s focused on doing the right thing for the patient,” she says.
A quiet but essential role
Hospice pharmacists may not always be visible to patients and families, but their work supports every part of hospice care. By navigating complexity, setting expectations, and keeping comfort at the center of every decision, they help ensure that symptoms don’t stand in the way of peace, connection and dignity at the end of life.
“At the end of the day, hospice is always patient-driven. What matters most is what the patient wants,” says Shannon. “I find it very rewarding to provide that sort of comfort and dignity — and hope.”