freddie Asked June 2012

How do I tell my mother who is fearful of death that it is time for hospice care?

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My mother has broken her 2 hips, ribs, back, and wrist in the last6 months and is nolonger eating much. She is 89 years old with severe osteoporosis and currently in a wheel chair. She has little strength for rehabilitation but continues to want to use a walker again which is pretty unrealistic considering her state of failure to thrive. The social worker said it is time for hospice but my mother wants to continue rehab to be able to walk with a walker. She is too frail to do this. She is afraid of death and I think if she was told she was going into hospice , she would loose her will to live.

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EXPERT Carol Bradley Bursack Jun 2012
Excellent advice all around. My parents benefited so much from hospice. They were able to live their lives without pain and with dignity - until it was time to die. You local hospice will have a chaplain who can help you along with the steps. Once your mother accepts she will die either way, she'll realize it's better to live in a way where she can enjoy her family. Take care, my friend. This is hard, but hospice will help the family, as well.
Carol
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kdaniels47 Jun 2012
This describes my mother and my situation starting last year. My mother loved life and intended to "stick around". A lot of how you approach the topic depends on your mother's mental state. My mother could no longer leave the apartment for any care, not yet bedridden but severe back and hip pain. Also unable to stand and barely walk without assistance. When her Dr told me it was time for Hospice I explained too mother that it was a service the Dr was prescribing for her to receive weekly nurse visits at home to make life easier for ALL of us. Even with some doubts and dementia she understood this concept. We did not use the word Hospice, but when necessary referred to it as Club H. The nurses even removed their ID badges (their idea)! None of this was a lie, we just put a different slant on things. The Hospice people are soooo nice and caring and spent real quality time with her. She loved the attention and additional weekly company. Also your mom may accept some "direction" from them that she won't from you, even if it is the very same advice. It all worked out wonderfully for us and my mom got the best care, she even thrived and gained a few pounds and I got the help I needed too. She passed away a few weeks ago, at home, in her bed with us around her. She was 2 months shy of 99!
Good Luck.
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JaneB Jun 2012
svalle, sending love and light to you all. My Dad was receiving weekly hospice visits but he is in the no eating and drinking phase of things, and hospice is here daily. It's a great gift for all of us.
My Dad, too, was against it. But when he "gave it two weeks" as a trial, he ended up liking that they came to him, that there wasn't the strain of getting into the car, etc. And he liked that it helped US deal with the strain of things. SO, Freddie, maybe ask your Mom if she'd do a two week trial. Also, the hospice people can explain that their services can go on for years, if need be, and that they have, for some people.

Good luck
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bunyip Jun 2012
Having a fear of death and wanting to keep living is a natural thing. When therapy fails to remedy, and at 89 that's a distinct probability then its time to make the most of life. Instead of denying the ultimate end we all face, hospice gives people the opportunity to die naturally, to prepare and do things that need to be done. Its a time to enjoy what life we have instead of trying to deal with frustrating medical interventions. Taking the last period of life and immersing yourself in life, enjoying it to the fullest, instead of using that time for unnecessary medical procedures makes sense. Hospice does not mean giving up, it means a chance to use the last period of life to best advantage for the patient and includes appropriate medical care augmented with spiritual and social care for patient and family.
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Dear Freddie, There is often a sigma placed on the use of the word "Hospice." Even among the medical community I found even some physicians don't understand their services. Another word which better describes the services they render is "Palliative" care - controlling a person's pain which allows them enjoy life a bit more. I had Hospice with both my husband and my mother and they were wonderful just as kdaniels47 describes. My advice would be to call a hospice care service near you and set up an appointment to talk to someone; they will be able to guide you on how to approach this situation with your mom. Good luck and keep us posted!
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jeannegibbs Jun 2012
If she goes on hospice that will pretty much mean that there is no hope for recovery. In fact, from the sounds of it, if she doesn't go on hospice there is no hope for recovery.

From the sounds of it, she is dying. If you don't think she would want to have to acknowledge this, I'm not sure it is necessary/helpful to insist that she face it. Instead of saying "there is no use in continuing PT; it is hopeless" I think that I might say, "We need to give your bones a rest to heal before we work on the walker any more." Is there any other treatment your mother would have to give up to receive Hospice Care?
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svalle Jun 2012
My mother was buried one week ago today..we only go to use Hospice for four days. In those four days the Hospice staff were just wonderful and helpful with my mother..I believe once your mother sees just how wonderful Hospice really is she will be happy they were there for her (( :
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hessaw Jun 2012
Hospice or palliative care is the best medical "discovery" since life began. It is all about easing the pain-actual and emotional -of loved ones leaving us and our missing them. Not everyone has the good fortune to get this care early; many wait too long to admit that death is part, the final part, of life. Hospice allows us, all of us, manage it with dignity and fortitude. Wonderful people, wonderful care.
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Jaye Jun 2012
I agree hospice was WONDERFUL for my Father. My son and I (we are nurses)did his actual care however they helped with equipment and medications. They were extremely supportive and caring!!!
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waddle1 Jun 2012
I liked kdaniels47 idea...and sort of practiced that approach with my mother, though not about hospice. To your mom couldn't the hospice people be "new friends" or "just visiting" or evaluating her for physical therapy or something like that. I understand wanting to protect her mental well being. I wouldn't want to take the chance of dashing that either. I wouldn't associate the word "hospice" with the visitors.
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