Medical Cannabis in Elder & End-of-Life Care
Many Mainers use therapeutic cannabis to ease the aches and ailments that often accompany aging, but what happens when mmj patients need to make the transition into senior living communities, nursing facilities, or hospice care? You will learn how these agencies currently address on-site mmj use, and how mmj patients and their family/friends can best prepare and advocate for their right to use cannabis therapies in a variety of senior care settings.
Presented by: Becky DeKeuster M. Ed. and Cathy Cobb
Medical Cannabis in Elder & End-of-Life Care Text
- Delivery Methods and Dosing: Making the most of your medicine Medical Cannabis in Elder & End-of-Life Care Presenters: Becky DeKeuster, M.Ed, Director of Education Cathy Cobb, Board of Directors Producer: Ben Gelassen, Marketing Associate
- Qualifying Conditions in Maine – Cancer – HIV+/AIDS – Hepatitis C – ALS (Lou Gehrig’s Disease) – Crohn’s disease/Inflammatory bowel syndrome – Agitation of Alzheimer’s – Nail-patella syndrome – Intractable pain (no response to traditional treatment 6+ mos) – Post-traumatic Stress – Severe symptoms such as cachexia, muscle spasm What’s missing? Depression AutismParkinson’s InsomniaAnxiety
- Maine’s Medical Cannabis Program: Access Source: Medical Use of Marijuana Program, 2014 DLRS Report(1) DISPENSARY CAREGIVER HOME GROWER Patients Served Unlimited Limited to 5 Self Retail Brick and Mortar No Storefront Allowed None Regulations Strictly Enforced No Active Oversight No Active Oversight Quantity 8 locations 2,161 individuals (1) Incl. in caregivers Growth — +80.5% over 2013 (1) Incl. in caregivers Access Points Under MMUMP
- • Patients must obtain a certification from either a M.D., D.O. or R.N. • Each patient must designate one source, two at the most, to procure their medical cannabis out of their 6 designated cannabis plants • Grow own + dispensary OR grow own + caregiver • Purchase limit: 2.5 oz every 15 days Maine Medical Cannabis Program: Patients
- Maine’s MMUMP Find full text of statute & rules, as well as other important information at: http://www.maine.gov/dhhs/dlrs/mmm/ Program Manager: Marietta D’Agostino MMUMP Office phone: (207) 287-4325 MMUMP in Statute – Title 22, Ch 558-C MMUMP in Rules – 10-144 CMR, Ch 122 Regulated by: Division of Licensing and Regulatory Services @ DHHS
- Types of Elder Care in Maine Senior Living Assisted Living Residential Care
- Types of Elder Care in Maine Skilled Nursing In-patient Hospice Home Hospice
- 2014 Update: LD 1779 provider facility or nursing facility, may use forms of prepared marijuana that are not smoked, including, but not limited to, vaporized marijuana, edible marijuana and tinctures and salves of marijuana. 4-A. Use and storage in inpatient hospice facility or nursing facility permitted. A qualifying patient who is a resident of a hospice provider facility licensed under chapter 1681 or nursing facility licensed under chapter 405, while in the hospice
- 2014 Update 4-A. Use and storage in inpatient hospice facility or nursing facility permitted. A qualifying patient who uses a form of prepared marijuana pursuant to this subsection may store the prepared marijuana in the qualifying patient’s room and is not required to obtain a registry identification card or to designate the hospice provider or nursing facility as a primary caregiver under subsection 4.
- 2014 Update 4-A. Use and storage in inpatient hospice facility or nursing facility permitted. A hospice provider or nursing facility is not required to be named as a primary caregiver by a qualifying patient who uses prepared marijuana pursuant to this subsection. This subsection does not limit the ability of a hospice provider or nursing facility to prohibit or restrict the use or storage of prepared marijuana by a qualifying patient.
- 2014 Update LD 1779 applies to nursing homes & hospice only (Does not address ALF, RCF, HH) Able to set own policies in conjunction with DHHS State & federal licensing guidelines available at http://www.maine.gov/dhhs/dlrs/licensing-rules.html
- Methods of Ingestion Inhalation* • Onset: 0-10 minutes; Duration: 1-4 hours • Benefits: Vaporizing; easy to self- titrate; immediate relief. Concerns: Odor; throat/lung irritation (smoking); short duration. Edible* • Onset: 20-120 minutes; Duration: 4-10 hours • Benefits: Discreet; variety of forms/flavors; long-lasting relief. Concerns: Determining appropriate dosage; easy to overdo. Topical • Onset: 10-45 minutes; Duration: 2-6 hours • Benefits: Non- psychoactive; discreet. • Concerns: Placebo effect. *Potential side effects (NOT topicals) Euphoria Increased b.p. Dizziness Change in space/time perception Hunger Sleepiness Anxiety/paranoia
- Benefits of Cannabis for Elder Patients Reduce opioids Reduce psychotropics (AHCA Quality Initiative 2016) Improve alertness Improve QOL 92% of those 65+ have at least one chronic condition 77% have two or more Elders aged 65-69 take an average of 14 prescription drugs Seniors are 13% of the population; they consume 40% of prescription https://www.ascp.com/articles/about-ascp/ascp-fact-sheet
- Planning: The Advance Directive Find Maine’s Advance Directive form here: http://www.mainehealth.org/wowadvancedirectives Plan ahead—make your wishes about cannabis use explicit in your advance directive! Helps your family Helps facility staff Helps your physician Image courtesy http://my.clevelandclinic.org/
- Delivery Methods and Dosing: Making the most of your medicine Thank you for your time and attention! What are your remaining questions & concerns?