Many may not know that Heart ‘n Home has a Hospice Pharmacist on staff. Trenton Jenks, PharmD, CGP, is our Senior Vice President of Clinical Services and runs the Pharmacy Department. Trenton is a Board Certified Geriatric Pharmacist, 1 of 15 in Idaho and 1 of 45 in Oregon. Heart ‘n Home is honored to have him as part of our team. Trenton is also a member of the National Council of Hospice and Palliative Care Professionals who are pharmacists from around the country that work on projects related to medications that will help hospice organizations around the country. The organization is currently working on looking at different classifications of medications that may no longer be beneficial for patients to take when they come to hospice. They base this on current literature and best-known practices throughout the country.
As a Hospice Pharmacist, Trenton helps educate our nursing staff on pain and symptom management. He also helps review each patient’s medications upon admission to assess for interactions, side effects, and effectiveness of their medications.
It is a misconception that once a patient enters hospice all their medications are discontinued and they pass away sooner. Medications are reviewed upon admission and they continue to be reviewed regularly. We never want to cause harm to a patient so with the changes that the patient is experiencing at end of life, taking all the medications that they were before may not be the best thing for them. Their body may no longer be able to handle the same dose or even the medication like it has done in the past due to the body slowing down. There is also something called polypharmacy, polypharmacy is when a physician adds on another drug to treat the side effects of the drug the patient is already taking. This can and does happen and so when our Hospice Pharmacist is looking at the medication list we are trying to see if there are any medications that are treating the side effects of a different medication. By doing this we can possibly discontinue medications and decrease the pill burden of the patient and still keep the patient comfortable and managed, but with fewer medications. There are also some medications that at one time was effective, but the disease has continued to progress even while taking the medications. So when the medication is no longer helpful to slow the progression of the disease, the risk is greater than benefit, or if side effects limit its continued use we may recommend to change or discontinue medications.
Comfort is a priority at Heart ‘n Home. Our team uses different scales to watch for in the patient to make sure that pain and other symptoms are managed and the patient is comfortable based on the patient’s wants. The patient is the one that steers the boat on what they want this experience to look like. Trenton, our doctors, and our nursing staff provide them with all the information regarding medications such as the effectiveness of medications, side effects, drug interactions, etc. This information is very useful for them to make the decision on which medications they would want to continue or discontinue.
If you know someone who could benefit from hospice and having a hospice physician help manage their medications, please contact us and we’d be happy to visit with you.