End-Of-Life Care and the Use of Antipsychotic Medications

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October 15, 2013 End-of-Life Care and the Use of Antipsychotic Medications The purpose of this Administrator Alert is to clarify any confusion regarding the attempt to restrict or prohibit the use of antipsychotic medications by the Oregon’s Office of Licensing and Regulatory Oversight (OLRO) for individuals receiving end-of-life care. End-of-life care includes hospice or individuals receiving comfort or palliative care. The use of antipsychotic medications for individuals receiving end-of-life care is not prohibited by Federal or State regulations. Antipsychotic medications are used to treat terminal delirium or other delirium in dying patients as well as nausea and vomiting. Haloperidol, specifically, is a highly effective drug used to treat delirium, nausea and vomiting for those individuals receiving end-of-life care. The additional benefits of using haloperidol include the availability of multiple dosing regimens and multiple forms: oral, intramuscular, subcutaneous or intravenous. Individuals receiving end-of-life care are expected to be supported throughout the dying process with dignity. In summary: Oregon Administrative Rules, do not prohibit the use of antipsychotic medications for end-of- life care. Use of antipsychotic medications to treat the symptoms of terminal restlessness is not considered a form of chemical restraint and is not intended to be withheld or refused by the facility if prescribed. To assist with clarifying the documentation requirements and evidence of an interactive relationship between the facility, Hospice and the individual and their family this Administrator Alert will be shared with the Oregon Hospice Association and the Oregon Home Health Association. For more information, contact the DHS Office of Licensing and Regulatory Oversight, 1-800-232-3020. Visit the DHS Web site at www.oregon.gov/DHS/ .

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