I first started making “house calls” to my home hospice patients in 1989. It was a privilege to be able to come into the house to see the patient in the often comforting disarray of their home and the love in action displayed by families and friend that were providing care. I quickly developed my own ritual or pattern for my visit, which included sitting and talking with the patient and family, a brief exam and review of medications and care supplies.
Early on while visiting a coal miner afflicted with mesothelioma, I found bottles for pain medication, constipation and other things the hospice had provide. Alongside these containers stood a mason jar with a curious pink colored fluid and lots of twigs, roots and leaves. The family shared with me that a friend with deep knowledge of herbs and Mountain Medicine had brought over this special tincture. The special concoction was to help with pain and slow the cancer down. I was invited to try a sip that tasted of vinegar and the woods.
Over the years, I have seen hundreds of home remedies, including Chinese and Indian traditional medications that immigrant families’ still valued and increasing numbers of Americans are trying. Also, as an oncologist, laetrile, derived from apricot pits, was only the first of a whole line of alternative treatments that desperate patients and families would hang their hope on for a cure.
I have never been harsh about this. If it seemed harmless, and was not an impediment to effective care; I wanted to know about the medications but not demand that they be stopped. Often I was concerned and discussed the financial burden for unregulated supplements.
Increasingly, these supplements are big business. Dementia, seems to be overtaking cancer as the most dreaded of disease. At least for cancer there are more ways to prevent and treat it but with dementia we have limited treatment options. Hellmuth and colleagues write in JAMA about “The Rise of Psuedomedicine for Dementia and Brain Health. Americans are spending $3.2 billion on supplements to promote brain health, prevent and treat dementia.
They discuss their approach to working with patients and families considering common psuedomedicine interventions which can guide Palliative Care providers who will see many of these patients. Learn more about psuedomedicine and how to discuss them to ensure the best care for our patients.