Palliative Care at Home: Using Medications Safely

Palliative care is an approach to caring for people who are living with a serious illness. Such care may be provided at home, and may involve providing comfort and improving quality of life by helping to manage symptoms such as pain, changes in appetite, difficulty breathing, sleep problems, and anxiety. A person who is receiving palliative care may need to take several medications, including some with a high risk of harm. Managing medications can be a challenge as the person’s needs and treatment plans change over time. Many people can be involved in a person’s care, making clear communication about the treatment plan very important.

ISMP Canada has received reports involving palliative care provided at home. Most of the reports have been related to managing complex medications, and miscommunication. Keeping accurate records of medications and detailed notes about communication within the care team lower the risk of medication errors. If you or a loved one is receiving palliative care at home, the following tips can help.

Learn about the medications. 

• Know what each medication is for, how much to take, and when and how to take it.
• Check each medication to make sure the name, strength, dose, form, and appearance match what you expect.
• Keep an up-to-date medication list, and ask the care team or pharmacist to review it regularly, especially when a medication is started, stopped, or changed.

Keep track of all medications, both prescription and nonprescription.

• Organize medications using blister packs or pill organizers, where possible.
• Set dosing reminders with cell phone apps or alarms.
• Record each dose using a chart/checklist, calendar, cell phone app, or diary, so that everyone involved in the patient’s care knows when the most recent dose was taken.

Review medications as needs change.

• If swallowing becomes difficult, ask the pharmacist or care team whether the medication is available in another form (e.g., a patch, dissolvable tablet, liquid, or injection).
• Remove old medications from the home after they have been stopped or changed.
• Share medication changes with everyone involved in care delivery.

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MedError newsletters are reviewed by consumers who are committed to improving medication safety. Learning from consumer reports is shared with health care providers through ISMP Canada publications. This newsletter shares information about safety medication practices, is noncommercial, and is therefore exempt from Canadian anti-spam legislation. *Funding support provided by Health Canada. The views expressed herein do not necessarily represent the views of Health Canada. Mederror is a component of the Canadian Medication Incident Reporting and Learning Prevention System (CMIRPS).