In hospice, comfort isn't a luxury, it’s the whole point. So, when symptoms show up in the middle of the night (as they often do), waiting around for a prescription isn't just inconvenient. It's unacceptable.
That’s where comfort packs and PRN medications come in. They both aim to bring relief when it’s needed most. But how they’re prescribed, delivered, and used makes all the difference in the patient’s experience—and the care team’s.
Let’s talk about how these tools work in the field, and why one might be better suited for the unpredictable rhythm of end-of-life care.
Comfort Packs: Ready Before the Crisis
A comfort pack, sometimes called a hospice emergency kit or e-kit, is a small set of medications delivered proactively to a patient’s home or facility. It’s stocked with medications to treat the most common and distressing symptoms patients may face, especially during after-hours: pain, anxiety, nausea, shortness of breath, terminal secretions.
The goal? To be ready. Not when the pharmacy opens in the morning, but when discomfort shows up at midnight, or a caregiver calls in a panic and says, “They can’t breathe. What do I do?”
A comfort pack ensures you don’t have to scramble for relief. It’s not a may-use. It’s a just-in-case-because-we-know-you’ll-need-it.
PRN Meds: Reactive by Nature
Now, PRN medications, short for pro re nata, or “as needed”, are prescribed once a symptom is already present. These scripts are filled individually, after a nurse or prescriber identifies the need.
They’re tailored, timely, and medically appropriate. But they come with one major catch: timing.
PRNs rely on rapid response. If the pharmacy is closed, or the courier is delayed, or someone doesn’t quite know what’s been ordered, or who’s supposed to administer it, relief is stalled. And in hospice, time lost is comfort lost.
Why the Distinction Matters
Hospice care is unpredictable. You don’t get to schedule when a patient will have trouble swallowing, or when agitation sets in. That’s why having meds on hand before the moment strikes matters so much.
Comfort Packs:
- Ease the burden on after-hours teams
- Reduce emergency pharmacy runs
- Give families reassurance and control
- Prevent unnecessary hospitalizations
Meanwhile, relying solely on PRNs can lead to delays, confusion, and a whole lot of emotional weight for nurses and caregivers who are left empty-handed when they need fast answers.
What a Better Comfort Pack Looks Like
At BetterRX, we’ve worked with hundreds of hospice teams to rethink the comfort kit, not just what’s in it, but how it’s used, delivered, and understood.
Here’s how we build ours:
We keep it simple: Too many meds create confusion. We focus on medications that treat multiple symptoms, across patient types, with clear instructions.
We choose wisely: We avoid meds that require refrigeration or precise timing if there are easier alternatives. For example, lorazepam tablets instead of concentrate—they store better and absorb well under the tongue.
We support delivery: We help hospices connect with local pharmacies that can provide same-day delivery for what isn’t in the comfort pack—so PRNs are still an option, but not your only option.
We audit what’s working: Our Comfort Kit Audits help reduce waste, adjust for real-world use, and streamline care protocols to avoid “just in case” overstocking.
The Recommended BetterRX Comfort Kit
While every hospice’s comfort kit should be customized, here’s a look at a typical BetterRX setup:
- Morphine 100mg/5ml (20mg/ml):
0.25ml every 30 minutes as needed for pain or shortness of breath
May increase up to 1ml as needed
(#30ml)
- Lorazepam 0.5mg tablets:
1-tab as needed for anxiety, restlessness, or nausea
May give multiple tabs for seizure activity
(#30 tabs)
- Promethazine 25mg tablets:
1-tab as needed every 6 hours for nausea or vomiting
- BetterRX Terminal Secretion Education for Families:
Non-medication guidance to help families manage noisy breathing episodes with confidence
The Bottom Line on Comfort Kits
PRN meds serve an important role. But a well-stocked, thoughtfully designed comfort pack ensures that relief is always within arm’s reach, not a delivery window away.
In the most vulnerable moments of life, no one should have to wait for comfort. That’s why BetterRX helps hospice teams simplify, streamline, and strengthen their approach to symptom management starting with the right meds, in the right place, at the right time.
If your comfort kit isn’t working as hard as your team is, we’d love to help. Contact our expert team today.
Rebecca Christensen, PharmD
