Reflection #1: Fadi Hasso, PharmD Candidate 2020
Dr. Nghia Pham spoke about hospice care and what that sector of pharmacy entails. The hospice movement was started by Dame Cicely Saunders. Hospice is now a Medicare part A benefit. Patients are assigned into hospice care if they have less than 6 months to live and may live at home, assisted living facility, etc. Average length of service is 71 days and approximately 1.6 million patients. Only 30 percent is related to cancer. Hospice, is common for many other conditions, especially now that people live longer due to medical advances. Pharmacist do not usually deal directly with patients, rather having a close relationship to doctors and nurses. At this point in life, medications are not used to cure rather to relieve symptoms such as pain, nausea, vomiting, metal instabilities, and delirium. Death is a challenging process to witness. Usually patients become sleepy, lethargic, obtunded, semi-comatose, comatose, then die. Others have a more difficult death which involves confusion, tremulous, hallucinations, mumbling delirium, myoclonic jerks, seizures, prior to death. The last 3 to 6 months are troublesome with many difficulties carrying normal life functions like breathing, eating, drinking, and withdrawing from society. Working in hospice takes a great deal of maturity. One must understand that it’s a privilege to care for someone during their last days of life.
Reflection #2: A Ra Hwang, PharmD Candidate 2020
Dr. Nghia Pham from Home Care-Rx gave a lecture on “Hospice Pharmacy: End of life care.” She spoke about working with hospices and her role as a pharmacist in Costa Mesa. Taking care of the dying began in the middle ages but in America it has only been 40 years. It is part A Medicare benefit. Palliative care comes before hospice and is for symptom control. It is paid for by the patients insurance and not the government. Hospice begins when a physician certifies patient has 6 months to live. Hospice patients can live anywhere from home to nursing facilities. Earlier hospice was related with cancer when there were no chemotherapy treatments and only radiation. I currently work at a closed door pharmacy and work with long term care, assisted living facilities, and hospices. I thought it was interesting to see that they give packets of medications for actively dying patients to aid with the process. Our pharmacy does not do that but it was interesting to see that. It seems that this pharmacy also compounds medications specially for patients into suppositories. I really liked that she talked about how it is a privilege to take care of patients.