Hospice and Congestive Heart Failure, can someone share information?

My husband was under hospice care in our home the last 22 months of his life and hospice kept him on all his medications including Lasix until he started his 6 week dying process and he could no longer swallow them.

My dad chose hospice for his end stage congestive heart failure after many years of treatment. His Lasix was continued while on hospice. He had it until two days prior to his death when he lost the ability to swallow pills. Interestingly, once he didn’t have it, there was no sign of swelling and no loss of oxygen level, he seemed exactly the same. A small gift while dying I suppose. Hospice was a godsend for him, lots of good advice and caring help. I wish you all peace during this time

My mother was on hospice with CHF for eight months. None of her medications, including Lasix, were discontinued until about three weeks before she died when it was clear they were no longer working.

Interestingly, when we stopped the Lasix, her edema completely went away. I always say my mother died happy, because she had slim ankles again.

DIL, my mom had end stage CHF when she went into hospice. Hospice did discontinue her Lasix - with the approval of her cardiologist, who had agreed to be mom's "hospice doctor", meaning any medication change (addition/removal) went through him for his approval.

They also discontinued some of her other meds. But the intake nurse was quick to stress: just because hospice recommends removal of a medication doesn't mean the patient has to stop taking it if they wish to continue. It *only* means that hospice will not provide it; but if your mom has a prescription plan, she can still get the meds the same as she did before, paying out of pocket, or through any sort of supplemental plan she might have. So even if *hospice* discontinues Lasix, it doesn't mean mom can't continue to get/take it if it helps with fluid retention.

Much like MJ has previously described, my mom's edema actually improved radically once she had stopped the Lasix, and she never had any sort of fluid retention issues after that, so the removal wasn't any big deal for her.

These are all questions that you should be asking the intake nurse when you meet with him/her. Our intake nurse sat with us for over 2 hours going over the program and answering all of our questions.

My mom actually lasted for 2 months in hospice, and during that time I thought they did an excellent job of keeping her symptoms under control and stable, even without all of the medications.

And my mom was ready. When it became glaringly obvious that the only thing the constant revolving door of doctor/hospital/rehab was doing was prolonging this sort of "half life" she was reduced to - house bound, sleeping all day, not having an appetite, not being able to do much because of shortness of breath, and all of the other things that go along with CHF, she was ready to cease the medical intervention and let nature take its course. This is where I felt hospice was an invaluable asset, because they ensured that she was kept comfortable the entire time, especially at the end when she was "actively dying".

I'm sorry for you and your mom to have to go through this. I hope your mom has as good an experience with hospice as my mom did.

I am so sorry you and mom are facing this.

I recommend interviewing several hospice providers. Make a list of questions, make notes and update questions from information learned at each interview.

Make sure mom and you both like what is presented and the people you meet, because it gets very intimate and you want people that make this easier for mom and her family.

Know what everybody involve expects and if those expectations are real and how hospice is going to meet those.

Ask hard questions and pay lots of attention to the answers and attitude. If they are evasive or get offended because you question them, this will continue through the care and you do not want to deal with that during this time.

May The Lord guide you to the best hospice provider, with the most caring staff and give you all strength, courage, wisdom and peace.

Hospice can and will use diuretics for comfort. Adding oxygen helps her get maximum benefit from every breath - like high test gasoline, instead of cheap off brand.
Morphine eases the cough reflex if she is having relentless coughing spells, the ones that are exhausting but not bringing up any phlegm.
There are some prescription cough meds that can be used, as well.
Please explore hospice care, it is much more effective for end stage CHF than medical care focused on prolonging life.

You can ask that question when she sees the hospice doctor. Generally current meds remain unless they have minimal value such as a statin. BP meds should remain.She keeps or may get oxygen. You will also see comfort meds added. Morphine may be given. Yet morphine is also a first line drug during CHF crisis.

not 100% sure but I do not think the Lasix would have to be discontinued as that is treating a side effect of the disease.
And by continuing the Lasix it may lessen discomfort that would come with fluid buildup so Lasix would be used for comfort.

I don't think so. Fluid build up is uncomfortable and hospice is all about comfort.

Not every Hospice company gives the same answers to questions like this, so it may be wise to interview more than one.