The nursing home is recommending Hospice. Help, I'm confused. What should I do?

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My Grandmother has been in a NH for almost 4 months now and has declined steadily. When I go to visit her it's hit or miss as to what she is going to be like. Somedays she is somewhat clear headed and able to talk to me directly but still will think she is at home or it's the first day at the NH. But most days she is competely broken from reality. Seeing and having conversations with people who aren't there. She says she's walking around a large beautiful house. She can't get out of bed and refuses to eat always saying she isn't hungry or "I just ate". The NH is suggesting Hospice care for her and all the info they have given me basically says she is at the final stages of life. I just don't understand. Could this be real? It breaks my heart that she is like this, it's hard to think. I've taken care of her for 6 years till she could not longer get out of bed on her own and we had to put her into a NH cuz I could not take care of her mentally or physically any longer. I have a 5 year old son and 3 year old daughter. I love her so much and we've had rough times but she was my bestfriend too. I'm just confused and scared. Please help. Part of me thinks she is having a psychotic break and just needs meds. She is 82.

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gryheart25,

"A person of any age is eligible for hospice after being certified by a physician as having a life expectancy that may be six months or less, depending on the course of the disease. If a patient lives beyond six months after admission they can continue to receive services as long as a physician continues to document the patient's eligibility."

Here are a few links that might you understand more of what is going on.

Your Parent is Dying: When Is It Time to Call Hospice?
https://www.agingcare.com/articles/When-Is-It-Time-To-Contact-Hospice-110692.htm

Hospice Care: Choose the Best Hospice for Your Elderly Parent
https://www.agingcare.com/articles/How-to-Choose-the-Right-Hospice-Care-for-Your-Elderly-Parent-136223.htm

Best of Luck,
Karie H.
AgingCare.com Team
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Getting a second opinion, if you aren't sure of her condition, is a good idea. My mom has hospice supportive care because her diagnosis is "failure to thrive", congestive heart failure. She also is diagnosed with Altzheimer's. Long story short, the meds for congestive heart failure (Lasix and certain blood pressure pills, and, I think, digoxin) in my mother's case seem to have aggravated her dementia symptoms. So, it could be that your Mom is on meds that make her seem worse.

If she is qualified due to her diagnosis and a second opinion says the same, then your loved one will benefit very much by the loving care hospice gives. Definitely ask a lot of people which Hospice group is the best in your area. Hospice also can supply a lot of the needed incidentals such as "ensure", pull ups, pads, etc.
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She is unable to walk. And, she is tired all the time. Sometimes she gets mad at me when I visit because I wake her up. She has been calling the NH "the tunnel".
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Please get another medical opinion from a doctor whom you trust. She may not be in the end stages of life, but right now, you don't know that for a fact.
Your instincts are correct to question the NH's assessment. She just may need meds or therapy.
If it is determined that she is end stages (refusing to eat, is one sign), hospice can be a great help. Hospice can take place anywhere - in home or at a hospital or NH.
I think that the word "hospice" sometimes frightens family members because it used to be a benefit that was reserved only for those who have 6 months to live.
However, regulations have been relaxed such that those who need extreme medical attention can now qualify.
I highly recommend getting a referral to a good hospice in your area (you do not have to go with the one that the NH or hospital recommends) and speak with the director. They are so great about explaining the process and answering your questions. Very often medical staff does not have this information.
Good luck...I know it is a confusing time. Having a correct diagnosis and more information will help greatly.
PS: is she unable or unwilling to walk? Getting her on her feet would help a lot to improve her health...
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My heart goes out to you, gryheart. Yes, you've understood the info the NH has given you: Hospice is for people who are at the final stages of life. No one can predict exactly that this person has 4 more months and this person has 3 more years to live. But with training and experience, professionals can usually suggest when Hospice is appropriate. You have been on this journey with your grandmother for many years, helping her and loving her. It sounds like Grandmother is now taking the final part of that journey. You can no longer help her in the same ways you were, but you will still be there for her, love her, and accept her love. Hospice can help you understand this part of the journey.
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