Opioids remain the cornerstone of symptom relief in hospice and palliative care, especially for pain and dyspnea. However, navigating reported "allergies" to opioids—particularly morphine and codeine—can pose significant challenges. In an already complex clinical landscape, these allergy labels can lead to under-treatment of distressing symptoms, unnecessary
As palliative care continues to evolve with an emphasis on quality of life, comfort, and symptom control, the incorporation of precision medicine tools like pharmacogenomics (PGx) offers promising benefits. Pharmacogenomics, the study of how a patient’s genetic makeup influences their response to medications, can serve as a powerful ally
In palliative medicine, attention to genitourinary symptoms is often overshadowed by more pressing issues such as pain, dyspnea, or existential distress. Yet lower urinary tract dysfunction—particularly the confusing coexistence of overactive bladder (OAB) symptoms and urinary retention—is both common and under-recognized, especially in older adults with complex comorbidities.
March is Kidney Awareness Month, a time often focused on prevention, early detection, and life-sustaining treatments like dialysis. These conversations are important—and incomplete. Missing too often is space for an equally valid, deeply human decision: the decision to stop dialysis. For many people living with advanced kidney disease, dialysis
We spend a great deal of time helping patients in maintaining stability—physically, emotionally, and socially. For individuals living with dementia, stability is more than a comfort; it is a lifeline. Disrupting it—especially through relocation—can carry significant clinical and emotional risks. Whether moving from home to a facility,
In palliative and hospice medicine, opioids remain the cornerstone of pain and symptom management. Morphine, codeine, hydromorphone, oxycodone, and other agents provide profound relief from pain, dyspnea, and certain distressing symptoms at the end of life. Yet, many patients arrive with their medical record littered with “opioid allergy” labels. These
As the hospice community deepens its commitment to equity and trauma-informed care, clinicians are increasingly caring for individuals who have experienced incarceration. These patients bring with them a lifetime of medical, psychological, and existential burdens shaped not only by disease, but by the enduring imprint of trauma, stigma, and institutionalization.
Prescription Drug Monitoring Programs (PDMPs) are state-run electronic databases that track controlled substance prescribing and dispensing. While they were originally designed as a tool to combat the opioid epidemic, PDMPs are now an expected part of safe, compliant medical practice in nearly every setting—including palliative care and hospice. For
Smiling is one of the most basic human expressions, universally recognized and deeply tied to emotion, social connection, and quality of life. In the palliative and hospice setting, providers often witness the gradual fading of a patient’s ability to smile. While at first glance this may seem like a
Introduction For many people—especially women, older adults, and those with chronic health conditions—recurrent urinary tract infections (UTIs) can feel like an endless cycle. Antibiotics may clear the infection temporarily, but the relief is often short-lived. Over time, repeated antibiotic exposure can lead to resistance, side effects, and a
When we think of aging, most people imagine wrinkles, thinning hair, or skin changes. Yet the most insidious change is less visible: the gradual loss of muscle mass, strength, and function known as sarcopenia. Beginning as early as age 30, we lose 3–8% of muscle mass per decade, accelerating
Sleep disturbance is one of the most pervasive and distressing symptoms in patients living with advanced illness. Families worry when their loved one is awake at night, clinicians search for safe non-opioid strategies to settle nighttime agitation, and patients often ask for something “natural” to help them sleep. For many
