As a hospice nurse with extensive experience in end-of-life care, I understand how challenging it can be for families and caregivers to make decisions about medical interventions, including the use of antibiotics, in the last month of a loved one’s life. Here are some pros and cons to consider when it comes to antibiotics in the last month of life:
Pros of Antibiotics:
Infection control: Sometimes, when people are extremely sick, they can get infections from bacteria. Bacteria are tiny living things that can make people sicker. Infections can cause symptoms and signs of something wrong in the body. Some symptoms of infections are fever, when the body gets very hot; pain, when the body hurts; and respiratory distress, when the breathing is hard or fast. Antibiotics are medicines that can stop some infections from bacteria. They can help your loved one feel better and prevent more severe problems from infections.
Improved comfort: When infections are treated with antibiotics, the symptoms of infections can go away or become less. This can make your loved one feel more comfortable and less unhappy. For example, if your loved one has a fever, antibiotics can lower the body temperature and make them feel cooler. If your loved one has pain, antibiotics can reduce inflammation and make them feel less hurt. If your loved one has respiratory distress, antibiotics can clear the airways and make them breathe easier.
Prolonged survival: In some cases, treating infections with antibiotics can make your loved one live longer, even if not for a long time. This can give you and your loved one more time to say goodbye, share memories, or do things that are important to you. It can also give your loved one a chance to finish their wishes, such as making a will, donating organs, or planning a funeral.
Cons of Antibiotics:
Reduced quality of life: When people are incredibly sick and close to dying, they want to feel as good as possible and enjoy their time with their loved ones. This is what hospice care is for. Hospice care is a special care that helps dying people feel comfortable and peaceful. Hospice care does not try to cure the illness but to make the patient feel better. Antibiotics are medicines that can stop some bacterial infections but can also cause problems. Some problems are nausea, which is when the stomach feels sick, and diarrhea, which is when the poop is watery and comes out too often; rash, which is when the skin gets red and itchy; or allergic reactions, which is when the body gets swollen and has trouble breathing. These problems can make the patient feel worse and less happy. Some problems can be nasty and even make the patient die sooner.
Minimal impact: Sometimes, antibiotics can help the patient feel better or live longer, but not always. It depends on how sick the patient is and what kind of illness they have. Some illnesses are challenging to treat, and antibiotics do not work well. For example, cancer is a kind of illness that makes cells grow too fast and damage the body. Antibiotics cannot stop cancer cells from growing. Sometimes, the patient is so sick that nothing can help them get better or live longer. Antibiotics may only delay the dying process, which can be challenging for the patient and their loved ones.
Impact on eating and drinking: When people are dying, they may not want to eat or drink as much as before. This is because their body is shutting down and does not need as much food or water. It can also be because they have trouble swallowing or digesting food. Antibiotics may not help with these issues and may even make them worse. Antibiotics can cause nausea, vomiting, or constipation, which are problems with the stomach or the intestines. Nausea and vomiting can make the patient lose their appetite and throw up their food. Constipation can make the patient have trouble pooping and feel bloated or in pain. These problems can make the patient feel uncomfortable and unhappy.
Conclusion
It’s important to remember that every situation is unique. Decisions regarding antibiotics should be made in consultation with the healthcare team and based on your loved one’s specific circumstances, wishes, and care goals. Hospice professionals, such as nurses and physicians, can provide valuable guidance and support during this grim time.
Ultimately, the primary focus of hospice care is to prioritize comfort, dignity, and quality of life for your loved one. This involves a holistic approach that addresses physical, emotional, and spiritual needs. The interdisciplinary hospice team can help provide alternative strategies for symptom management and offer support to the patient and their family.
Remember that you are not alone in this journey; support is available to help you navigate these complex decisions. Contact your hospice team to discuss your concerns and receive the guidance and reassurance you need.
