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Patient is in the home at present. I am not sure how the protocol between hospice and nursing home works if I admit my mom to a nursing home that has a contract with hospice. I can monitor medicines at home an make sure she is just not doped up on pain pills I am afraid if I admit to a nursing home that has contract with hospice they will just give her pain pills.

How do you get someone into a nursing home directly from home? I am told if not under hospice you have to go from the hospital.

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the overdose of morphine happened the night they started hospice. I asked for her medical records and they did not send medication info. I called them and they said I don't need that since she died. they know they were wrong.
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I am so sorry you experienced that, lizzy48. In my mother's case the NH staff did defer to the hospice orders. Was your mother on hospice long when this happened?
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Veterans, unfortunatly in my mother's case this wasn't true. A nurse accidentally gave her an "as needed" morphine dose right after low dose just started from hospice because she was acting funny. 10mg two hours after her 2.5mg low dose just started and supposed to be every 6 hours. She had seizure and never came out of it. They never called myself or hospice. I came in that afternoon and found her on oxygen etc..had to ask charge nurse what was going on? Asked why they did not call me DPOA or hospice and she said "well the Dr was here so she took off morphine and put her on oxymoron and seizure protocol". I believed that hospice would be in charge and at the very least I w would be called. Not so. She died 13 days later. My brother and I got to watch this. No food or water. Anyhow point is I thought hospice was main people to be in charge and it was not for us. It was a mess. NH staff made decisions they wanted to. It made for an comforting, painful and distressing death.
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Using hospice in the nursing home does mean they call hospice for med changes instead of the nursing home primary care doc, that can be either good or bad. Probably good if everyone on call for the hospice is in sync with your wishes and readily available. They may not do more than that and send a companion for some visits or one on one care activities that the nursing home staff would not have one on one time for. Some nursing homes, if not using hospice will require hospitalization when certain symptoms develop; my mom's actually transferred her to inpatient hospice when she was having chest pain and unresponsive spells rather than try to manage that at their facility. They let me know right away and I met Mom there so I would have been there if she had not stabilized and had passed right then...but if the hospice had been further away from me than the nursing home that would NOT have been a good thing. Hospice used to be more familiar with verbal, appropriate patients who were dying of cancer than with heart disease and dementia, but that may be gradually changing. They were less comfortable with Mom having agitation and outbursts than the regular nursing home staff was but we we able to stay full time with Mom there and better able to help clam her down too. Every situation is going to be very individual. I saved an article on "The Dying Dementia Patient" that I could try to find again if it would help anyone else.
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what are the disadvantage of using hospice in a nursing home.
She is on dialysis Can she keep her insurance with Medicare, GMP and Medicaid. Does hospice come everyday to see them and feed the patients
Just what do they do.
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My mom 86 is at a similar stage and diagnosis and just went on hospice two weeks ago. Came off all meds for blood pressure and diabetes, only taking depression and anxiety (comfort meds) at this time. She is not bed bound and lives in a residential care home, still participates in activities, gets up and dressed each day, home-cooked meals at the table with her housemates. She broke her ankle in January and went under 100 pounds refusing to eat. She is now eating better (probably thanks to being off so many meds) but qualified for hospice with a very rapid decline since July and now sees a nurse twice a week (compared to a doctor every 6 weeks), brought in the hospital bed which her caretakers were very grateful for, and gets a lot more medical attention as it had gotten much too hard to take her to doctor appointments, not only my brother having to lift her in and out of the car, but the waiting and waiting just was too difficult for her. Hospice services were the perfect fit for her. She refused surgery early on and wants nothing to do with life sustaining measures at this point, just comfort. At her age I would choose the same course for myself.
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By the time hospice is called in most patients are not ambulatory anymore. That's why a hospital bed, which hospice provides, is so essential. It makes caring for the person so much easier.
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I will add that at this time, thankfully Mama does not require a lot of pain meds. We have morphine if and when we need it and so far thankfully have not needed it much. I do breathing treatments as needed. We have oxygen available if needed. The nurse helps with all of it and would help more if I needed her to. She has always told me to call her at any time whenever and I have done so a few times and can say they have responded quickly. I am like Jeann for me it is a Godsend...and for Mama as well
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My Mama is on hospice with advanced dementia and mid stage alzheimers...She too, will be 90 in a couple of weeks. Mama had been doing relatively well, following a horrible fall a couple of years ago. While no one expected a recovery from that, she miraculously pulled through. I left my job, my home, and moved back to my hometown where I care for her 24/7. I did not have home health or hospice for the first two years...of course would not have qualified for hospice...but just before Christmas, Mama broke her ankle of all things while getting on her potty chair. I was standing right beside and thank God she landed on me, but she still fractured her ankle...not a bad fracture, but required surgery, or so they said. I fear the anesthesia had a horrific effect. Mama went from being able to sit in her lift chair all day and be somewhat communicative, to now being totally bedfast, unable to lift herself whatsoever. We are unable to even get her into a wheelchair. She qualified for hospice, and they told me that while she did not appear to be in immediate peril, they would be here for us in whatever way we needed. I get aggravated at the health care aids who come three times a week to bathe her, but overall, I have gotten very used to her nurses and actually look forward to seeing them. I am working on the bathing aids as I am seeing that some of that perhaps I could let my needs be known more clearly and they will work with me...they are here after all to make your Mom comfortable and help you..right? For me, having Mama home is a Godsend...I know Mama always told me not to let her frailties get in the way of my life and never do what I am doing but for me, I actually can deal with this better here with her. that is just me, but when she was in rehab a couple of times, I was there so much that for me THAT was harder than her being home. She is here, and even though she doesn't always know who I am anymore, we have little moments here and there when I can see somewhere deep inside she knows she is ok. It is heartbreaking a lot of the time, but I think this is the only way I will be able to let her go when the time comes. Prayers to you and your Mom.
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Why are you considering hospice at this time?
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Holler when my time comes, just keep me happy, please. Forget giving me any medication except happy pills, bake me some special brownies. If I am bedbound, just pass me the morphine clicker and set the level to total relaxation. Forget the feeding tubes and the oxygen and IV's just get me to my happy place and let God do the rest.
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My mom does not walk,doesn't recognize most of the family members. But the doctor's have not said her life span is six months or six years. She is 90 years old and the pains come an go. She fell twice in a personal care home no broken bones or fractures but since the last fall she is afraid of falling and will not walke. She was in rehab twice.
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Hollerfatgirl, is your Mom in the final stage of dementia? Is she likely to die relatively soon? That is what hospice is for. Managing pain and anxiety and agitation, etc. is the goal of hospice. It is not about curing anything, but making the patient comfortable and helping the caregiver and other loved ones through this final journey.

If your mom is eligible for hospice you can have it at home or in a nursing home or in a special facility devoted to hospice care. My husband had hospice care at home. It was wonderful.

If mom goes into a nursing home she will not be on hospice care unless 1) she is eligible for it (that is, she is likely to die soon) and 2) she/you agree to it.

Is your mother in a lot of pain now?
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