When someone with advanced cancer is waiting for a hospice bed, the wish to spend some time at home is common and completely understandable. Familiar surroundings can be a comfort in themselves. Because home does not offer the immediate injections or procedures a hospital does, planning ahead for "which medicines to have on hand" before discharge can prevent a great deal of worry.
It helps to think of pain medicine in two groups. The first is regular, around-the-clock medication taken on a fixed schedule — often a long-acting form such as a transdermal patch (for example, a fentanyl patch) or a slow-release oral tablet. The second is rescue medication for breakthrough pain, a fast-acting drug used only when pain suddenly flares. Even when pain comes and goes rather than staying constant, having a rescue medicine ready for sudden spikes can be reassuring.
Just as important are the medicines that manage side effects. Opioid painkillers almost always cause constipation, so a laxative should be started alongside them from the beginning, not added later. Nausea can appear in the early days, so an anti-nausea (antiemetic) medicine is worth having too. Do not forget regular medicines for other conditions such as blood pressure or diabetes, and any drugs already used for symptoms like tingling in the feet.
When collecting the discharge medicines, a few extra steps help. Ask whether you can receive enough days' supply to cover the time until the next visit or hospice admission. Ask the team to write down, on paper, how to use each medicine — when to change a patch, and how many times a day the rescue medicine may be used. And ask for a referral letter and an up-to-date list of current medicines, so a nearby hospital or emergency room can take over smoothly if needed.
At home, it can be hard to judge when to call for help. It is safer to contact your chosen hospital or emergency department when pain is not controlled even after the rescue medicine, when swallowing becomes difficult, or when there is fever, breathlessness, or a drop in alertness. Choosing to stay home for a while before hospice is entirely possible; what matters is being prepared to keep pain and symptoms comfortable in the meantime. Because the exact drugs, doses, and instructions depend on each person's condition, always decide them together with the care team.
This article is general information and does not replace the diagnosis or treatment of an individual patient. Please discuss the choice and adjustment of medicines, and any home-care plan, fully with your care team.