Date of Award

6-2020

Document Type

Union College Only

Degree Name

Bachelor of Science

Department

Neuroscience

First Advisor

Carol Weisse

Keywords

Haldol, Hospice, Home Care, Informal Caregiver, Caregiver Burden, Medication Administration, Haloperidol, Hospice

Abstract

At the end of life, most individuals express an interest in remaining at home and home

deaths are trending upwards in the United States. While this may be desirable, there are numerous complex symptoms such as delirium, agitation, and nausea that can occur as death approaches. Hospice prescribes medications such as haloperidol (Haldol), but oftentimes, the responsibility of administering medications falls on family members. Managing medications can be complicated by side effects, polypharmacy, caregiver characteristics, and inconsistent professional support. This study set out to examine how often informal caregivers make Haldol administration decisions by examining the records of 317 hospice patients (188 women, 129 men) who died at one of two community care homes. To assess prescription practices and drug use, PRN and scheduled doses of Haldol prescribed and administered were recorded for the first and last 24 hours at the care home. Haldol prescriptions were common; 98 patients (30.9%) were prescribed the drug at some point. Analyses of changes in drug use showed a significant increase in the average maximum total dose allowed in the first 24 hours (3.42mg) and the last 24 hours (5.67mg) (t(82)=-3.37, p=0.001) as well as in the average amount of Haldol administered from the first day of care (0.78mg) to the day patients died (2.69mg)(t(82)=-3.75, p < 0.001). These findings show that caregivers of dying individuals at home may require additional support.

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