Calling Hospice for Terminally Ill Parents

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Once a terminal diagnosis is given by the doctor, when can hospice can be called in? When the patient is expected to live less than six months.

I hear often that many people think you only call in hospice during the last couple of weeks of someone's life. Often, their loved one suffers needlessly, and the family lacks the support they could have had with a good hospice team at their side.

I've known people who have gone on hospice care more than once. They beat their disease back for a time, went off hospice care and lived decently for awhile, then called hospice once more when the symptoms returned. This is not highly unusual.

Paying for Hospice Care

Most health insurance covers hospice care. Medicare covers hospice care. At this time, anyone declared medically terminal, with six months or less to live, is qualified to call on hospice for care.

Hospice will come to wherever the patient calls home, whether it's a residential home, an assisted living center or a nursing home.

Hospice also works as the palliative care team in many hospitals, so if a terminal person is hospitalized and will be more comfortable in the palliative care unit than a room where "cure" is the only language spoken, then the palliative care unit is most likely where the person will be cared for. Palliative care simply means caring for people who are dying by keeping them as comfortable as possible.

Again, this implies an acceptance of impending death.

No One Needs to Die in Pain

One well-used hospice motto is, "No one needs to die in pain." That is the essence of palliative care. So, why wait until someone has suffered months before calling in hospice?

Yes, the person dying, and the family, have to come to grips with impending death, but most of us would rather die with relative comfort than in agony, and if that means coming to grips with reality in order to make this possible, then I'd recommend working on that. A spiritual leader can often help families get to this point of acceptance.

Once acceptance is reached - at least enough acceptance to pick up the phone and call your local hospice - you will likely find that their expertise and compassion will help all of you internalize this acceptance and come to terms with the reality of death, which is something we all must, one day, face.

The compassionate care of our hospice allowed my family to have quality time with our parents during their last months. Hospice care allowed us to be present as Dad and Mom passed out of this world, in peace. Since my parents were going to die no matter what I did, I couldn't ask for more.


Elder care author, columnist and speaker Carol Bradley Bursack is an AgingCare.com contributing editor and moderator of the AgingCare.com community forum. Read her full biography

 
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Comments

 
  •  Comments 1 to 10 of 15 
 
 

This is what really irks me about the whole Hospice situation. Why do we have to wait until we get "permission". if I had it all to do over again, I would have called Hospice so much sooner. In order to admit her to hospice care, my mother only had to be diagnosed with an "Adult failure to thrive" condition. I don't think enough people are aware of this. Also, many Hospice organizations also provide palliative care which can be so helpful long before a person is on the verge of dying. No one is telling the caregivers these things. it is so important to get the word out so that families can get the services and support they need desperately at the end of life.

 
 

anonymous13319

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Apr 25, 2010

Despr: thank you for this information...it would be a shame for others to go through what you did with your mother. You are kind to share this with us.

 
 

zumbakat

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May 16, 2010

However, with hospice care, I've been told the person must have a DNR and no treatment such as radiation can be given.

 
 

oliviajr

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May 23, 2010

My mother has dementia along with a whole list of other stuff. I have talked to her PA but he says she is not ready for hospice. When do you know because I don't know how much more time my mom has. It could be 1 day or 5 yrs. And can you get in home hospice care.

 
 

pooh4292

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May 25, 2010

My grandmother's DNR was optional, and we chose to enact it, and she would not survive any measures to save her life anyway, nor did she want to go through what it would take if the need arose. I dont think hospice means DNR is mandatory, as a matter of fact, DNR's can be revoked at any time, orally even.
As far as when it ws time for nana to receive hospice care, after she recovered from her broken hip (as much as possible), they focused on her lung problems, which were more serious than we could've ever imagined, she was unable to do progress in pt as medicare requires becaue her lungs wouldnt do the work required...after 2 hospitalizations and the dr seeing nana decline along with referral from the home care that was her rehab team, she placed into hospice care, in my home, immediately, and they really jumped in with both feet. They provide all care here, that is their purpose to make the patient comfortable so they can live out their final stage of life out of the hospital. I dont even take nana to dr's appts, the hospice nurses, doctor and our family doctor work together as a team and take care of her needs that way. They're great. Even has an aide who comes and bathes her, a social worker and a chaplain. They have volunteers too, to give me a break, but she wont have any of that. Anyway, that's my experience before and during hospice care so far. Hope it was helpful, and I took a couple of weeks between pt suggesting it before i asked the dr what he thought, i researched what hospice means, and then talked to the dr. Best of luck to you.

 
 

oliviajr

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May 25, 2010

Thank you. When my mom goes into the hospital I do a DNR on her because she would not make it thru it either. She had a hip replacement last July so I know what you mean there. The last time I took my mom to the er was for a GI bleed and that is when the doctor at the hospital talked to me about hospice,so on her next next doctor doctor appt. I talked to him about it and he said she was not ready that she was not going to die in the next 3 to 6 months. So who do you trust hospital or her regular doctor. I have found I think a wonderful hospice center that I think will come to my house.

 
 

pooh4292

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May 25, 2010

i would notify the hospice center you found and have them do an evaluation...

 
 

Bobbi

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May 25, 2010

If anyone has questions about Hospice, all they usually have to do is pick up the phone and call them. Ask questions, lots and lots of questions. If the time is not right, then at least you have information in hand. If the time is right, then you can have services begin. I personally cannot sing the praises of Hospice enough. I agree with the above, having a DNR does not mean that you cannot change your mind....at any time. Most people who enter Hospice do not want life prolonging measures.

 
 

oliviajr

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May 25, 2010

Thank ya'll so much I will call and atleast talk with them and go from there.

 
 

Eve

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Jun 3, 2010

My father has alzheimers, in feb. 2010 had a massive stroke. He is unable to speak, move, incontinent, and has to have all his food pureed. Then I need to feed him. He is in my home and I am his caretaker. He is also 90 years old. He has had infection after infection, sleeps 90% of the day, as of late hardly eats or drinks. Vital signs are erratic, just a mess. We had a home health agency when there time was up we requested in home hospice care. My question is how do you know if your parent needs hospice? or should he go back to Health Care.

 
  •  Comments 1 to 10 of 15 

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