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Home Health Care Providers and Hospice Providers: Okay, twice now within the last two weeks, i have heard two horror stories, one of our own and one from an old friend from way back about Home Health Providers and Hospice Providers who think they have the authority to make a decision on patients with Home Health Care or who are in Hospice Situations. 1) In our case, our Mom has digestive issues and the last radiology unit who came to do a swallow test, basically told us to just stop feeding Mom and put her on a feeding tube, 2) the physical therapist told us that if we have to call them again for service, then he will suggest putting our Mom is a full time rehabilitation center and 3) my friend told me that his 87 year old father is in Hospice and within weeks of his life and the Hospice people told his wife/Mother that she should just stop feeding her husband of 64 years and let him die of starvation! WHO THE HELL do these people think they are? Really, it is NOT our decision to take a person's life, unless of course there are drastic conditions and that the wishes of the patient are to be removed from life support. Really, it's GOD's choice to end a life. WHO THE HELL tells a woman married to a man of 64 years just STARVE your husband to death so he will die faster, don't prolong his life? Really, let me just ask you this, if it were YOUR PARENTS or spouse or significant other, would you ALLOW these people to say this in your home, in the presence of the person being cared for, to your family? REALLY, These people think they are GOD while the patient is PAYING FOR THEIR SERVICES and believe me, they are NOT cheap! I cannot believe that providers are allowed to do these things! Just had to say this, in our case, Mom is alive and well, and no, not in the best of health, but we make the best life we can for her as I'm sure everyone else does for their parents. Be SUPER CAREFUL with home health providers and hospice, the decision is up to the patient and the Lord, not up to us, we ARE NOT GOD!

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FRAULEIN, these health care providers are making suggestions or giving advice, based on their training and experience. That is their job. They cannot force you to follow their advice.

1) The advice to use a feeding tube is a way to continue nutrition when swallowing is risky. It is NOT about starving someone -- it is about feeding them in spite of the high risk of trying to eat. There are pros and cons to feeding tubes, and that is a decision the family must make, if it is medically advised. Advising a feeding tube is not playing GOD, it is offering an alternative way of feeding someone.

2) Many people do go into rehab centers, for more frequent and intensive therapy than can be provided at home. My mother has been in rehab centers twice and my husband once. Rehab was advised for my husband a second time, but I declined for him (because of his dementia). The medical professionals give their best advise. Families get to decide whether to follow the advice. Advising a stay in rehab doesn't seem to me to be playing GOD. Saying "We've done what we can in a home setting. If more is needed, we advise in-patient therapy" does not seem to me to be something to be angry about. If you don't think it would be in your loved one's best interest, just say No.

3) When someone is in the process of dying, the body starts shutting down. It no longer needs or can use nutrition. Stopping feeding is not starving them and does not cause their death. They are already dying of something else (that is why they are on hospice care). The hospice nurse is not trying to hasten the death, but to make it more natural and more comfortable. Again, the family can ignore this advice and continue with feedings if that is their decision.

As you say, the services of these medical professionals are not cheap! You are paying for their knowledge and training and experience. They would not being doing their job if they did not offer you their advice. And as you say, the decisions are not up to them.

Yes, I would (and have) allow professionals to say those things in my house. I would expect them to. I would take their opinions seriously and give them thorough consideration. Then I'd make up my own mind what to do. Sometimes I have followed their advise, and sometimes not. I have never felt that they were doing anything but their job.
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I think all this emphasizes the need for the individual to spell out in writing their end of life choices before they are incompetent to do so. To burden family members with these decisions is unfair. We need to face up to the fact that unless we die young, we will all grow old and die. Health care professionals often do care about their patients and families are often blinded by emotion. Keeping aged folks alive with extraordinary methods is a huge business. It is the health care professionals financial interest to keep them alive. So if they encourage no further intervention, it would be their financial loss.
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I can agree that these home health care providers are doing their job, but for petesake, have some discretion and discuss it in private with the family and not in front of the patient. Some of the one's we've had for different things have been total jerks and i will not allow that behavior in my home. Absolutely not acceptable and treating my Mom with that kind of disrespect will definitely get you reported for one and kicked out of my house for two. My friends beloved father passed away a week or so ago and is at peace now. His beloved wife fed and cared for him till the end. God bless them both. My Mom continues to fight, do her speech therapy and pt and is doing well. So proud of her and her strength and courage to keep fighting and living every single day. We are blessed.
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