A comfort pack, often called an emergency kit or E-kit, is a prearranged set of prescription medications and necessary supplies kept at a patient’s home during hospice care. This kit is designed to provide rapid relief for common, sudden, and distressing symptoms that may occur during the end-of-life phase. Having these items immediately available helps the hospice team address medical crises without delay. The comfort pack ensures that prompt symptom management can occur at any time of day or night.
The Essential Components
The specific contents of a comfort pack are customized based on the patient’s diagnosis and anticipated needs, but they generally contain medications addressing four core symptom categories:
- Managing severe pain and shortness of breath, often including liquid opioids. These medications work quickly when the patient’s regular pain schedule is insufficient.
- Targeting anxiety, agitation, and restlessness, frequently including benzodiazepines. These drugs help calm the mind and reduce fear.
- Controlling nausea and vomiting (antiemetics), a common issue for many hospice patients.
- Managing respiratory secretions (anticholinergics). As a patient nears the end of life, they may lose the ability to clear mucus, and medications like atropine drops reduce the production of these secretions.
Supplies such as gloves and oral applicators may also be included to facilitate safe administration.
The Primary Goal and Function
The primary function of the comfort pack is proactive symptom management, ensuring that acute discomfort is addressed immediately. The kit is intended for use when a new symptom emerges suddenly or when existing symptoms worsen rapidly, requiring an urgent response. This immediate availability prevents the distress of waiting for a prescription to be filled or delivered during a crisis.
The presence of the comfort pack gives caregivers peace of mind that they are equipped to handle unexpected declines in the patient’s condition. Having these targeted medications in the home allows hospice care to quickly provide relief, maintaining the patient’s comfort and dignity. This strategy prevents unnecessary and stressful trips to the emergency room, keeping the patient in their preferred environment. The medications in the pack are specifically for urgent, breakthrough symptoms, separate from the patient’s scheduled daily medicines.
Practical Guidance for Administration
The most important instruction is the necessity of contacting the hospice nurse or physician before administering any medication from the kit. The nurse is available 24 hours a day and will provide specific guidance on which medication to use, the correct dosage, and the proper route of administration. Caregivers should never use the medications without direction from the hospice care team.
Typical scenarios requiring the use of the kit include a sudden spike in pain, uncontrollable nausea and vomiting, or acute agitation and air hunger. The nurse will direct the caregiver to the specific medication class intended for the observed symptom, such as instructing the use of a benzodiazepine for severe anxiety.
The medications are often provided in non-oral forms because a patient experiencing acute symptoms may have difficulty swallowing. Common routes of administration include sublingual (under the tongue) liquids, rectal suppositories, or injectable forms. If the patient can no longer communicate discomfort, the caregiver must look for physical signs of distress. These signs can include restlessness, moaning or crying out, grimacing, or increased tension in the body or face.
Acquisition and Management
The process of obtaining the comfort pack is initiated by the hospice nurse or attending physician, who orders it based on the patient’s potential needs. It is important to have the medications delivered at the start of hospice care, ensuring they are ready for immediate use if symptoms worsen. The cost of the comfort pack is typically covered under the patient’s hospice benefit.
Proper storage is mandated to maintain the drug’s effectiveness and ensure security within the home. Many comfort pack medications, especially liquids, require refrigeration to remain active. For safety, the kit must always be stored out of the reach of children and pets, and hospice agencies often recommend using a lock box because it contains controlled substances.
The hospice nurse monitors the medications during routine visits, counting and checking the contents of the kit. The comfort pack is prescribed only for the patient and must not be administered to anyone else. If the patient passes away or is discharged from hospice care, the unused comfort kit must be disposed of properly according to the hospice agency’s protocol for controlled substances.