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Hi everyone, just wanted to give you a quick update on my dad. The hospice group who initially was "treating" him (more like trying to euthanize him) finally got on my mom's and my last nerve and we moved on to a new group called Crossroads. They have been great. They are giving my dad Remeron and it's really helped him to regain more appetite and his sleep is better. He is joking even more than he used to. He is happy. This new agency has been great. I've not seen my mom this relieved and pleased with my dad's care in months.



There has been an alarming uptick in the number of hospice groups obsessing on getting their death numbers up as quickly as possible in various parts of the country. The group we just left had many signs of being just that- a euthanization activist group rather than a palliative/hospice/comfort care agency. Keep a close eye on your loved ones. Don't jump to conclusions of course and don't assume that all hospice agencies are corrupt (because they definitely are not) but just be aware that sometimes there are problems and you may need to switch.

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I am currently looking to switch agencies, and when I spoke about the issues I was having with the state DOH, I was told that they are a "deemed status" hospice (https://www.jointcommission.org/resources/news-and-multimedia/fact-sheets/facts-about-federal-deemed-status), basically given a green flag by the feds and not required to participate in care quality surveys.

The CEO retired in 2020, and there's a new one in her place. With such a drastic management change, I'm wondering if they no longer deserve that status based on how poorly my experience has been going.
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So happy that you are satisfied with your current hospice situation. Hospice organizations are not all the same and research is needed to select one.

I always tell people to switch to another provider if they aren’t satisfied.

We switched providers too but it was about staffing.

A nurse that mom loved told us that she was going to work with another provider. She knew how attached mom was to her and she had grown very close to my mom. So, she let us know the name of the new provider so that we could switch to them and keep her as mom’s nurse for the remainder of her life.
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Unfortunately too often people believe that when hospice is brought it it means the client is at death's door, and I think that some hospice staff are overly focused on the end of life part and don't work hard enough on the living your best life possible until the end part - IMO that's a fundamental lack of understanding and training. I'm glad you found a different hospice group that gets it!
(BTW my also mom did very well on mirtazapine)
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It doesn't make sense to me either. I would think that the longer the patient holds on the longer you can collect money from Medicare, right? But I've read a few articles talking about this in various locations. Apparently there is some reason some places are incentivized to do this. And some people are of course just flat out political in the sense that they feel all dying people need to be put down as soon as possible.
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Amen to that. In our case, the agency was repetitively intimidating my mom (who, despite her arthritis and slow movement is VERY stubborn in doing what is right and will not yield to bullying tactics- she definitely saved my dad's life) into giving him huge amounts of morphine around the clock despite it forcing him into respiratory failure twice. When that happened and he looked grey the nurses said, "Oh, see? He is transitioning and you need to make plans." They said he was transitioning at least 25 times during the 4 months they were with us.

Funny, not a single nurse in this new agency thinks he has been acutely "transitioning" yet. Yes, he is 91 and winding down and will of course not live forever but he's not actively dying every. single. day. Good grief.
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Seriously - there are hospice groups obsessing on getting their death numbers up quickly? Why?

It's a built-in that the people who go into hospice care are close to death. Unless the patient leaves hospice for some reason, they'll die under their care. I can't imagine why hospice would need to get their death numbers up when it's going to happen anyway.
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I fired my dad's first hospice company, too. They weren't trying to euthanize him, but they were slow to respond to calls and their social worker was a nightmare, scolding me that "This isn't about you" when I asked if they had support services for the family.

The bottom line is that a hospice organization is part of your family's caregiving team, and if they aren't receptive to the "coach," then they're off the team. Any organization that doesn't understand who they work for needs to go, and it's very easy to switch hospices.
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