Making our final decision about hospice. Need advice.

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Mom is on a downward spiral and now has pneumonia on top of her severe COPD, bedsores, broken pelvis and arm, etc. Making no sense and getting more incoherent daily probably due to the morphine and dilautin for the pain. Also on Lexapro and xanex and lots of COPD drugs.

Family awaiting OK from one more relative and then will call nurse to put her in hospice care in her nursing home facility.

Questions: (I can ask nursing home staff this, but cannot reach til tomorrow, Monday.)

1. If in hospice...Would she continue her oxygen and COPD meds? I take it that is part of keeping her comfortable without "improving her health"?

2. If she lived a few months and her $ ran out for hospice/facility care ($10,000 month) and she had to apply for Medicaid, would they still keep her in the facility with hospice while application is pending?

3. Would we receive the name of separate Hospice contact (they said this person would be with her at least 2 hours a day) to deal with at other times?

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I finally convinced my brother that hospice is best and was all set to start the hospice ball rolling yesterday. Then my sister went to visit her and found that even with her newly diagnosed pneumonia she was doing therapy, albeit just eye/hand cooperation. Mom was also still 95% loopy. We were shocked.

I am going to talk with various nursing home personnel today before informing everyone to start hospice.
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Waiting for one more relative? Is that relative POA? If not, please take the bull by the horns and sign on to Hospice. Please get your loved one out of pain.
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I don't think that you should wait for another family member to help decide the obvious. Your Mom needs Hospice right Now! I would bet that they will continue her COPD meds, as they are helping to keep her comfortable. Don't be surprised if they amp up her pain meds, the Morphine, and anti-anxiety meds even more, as comfort is the key to life ending diagnosis. A person in this much pain, would probably rather be OUT OF IT, than be in such excruciating pain, I know I would, so therefore, she will probably be sleeping most of the time. We had our own Mom on Hospice, in my sisters home, and it's all about comfort for the patient. It is sad to see the in so much pain, my Mom had a fractured pelvis too, from Metastasis from her uterine cancer. We cannot even imagine how that feels for them. My experience with Hospice was wonderful! Please take advantage of everything they offer, as it will help to comfort you as well. You are doing the right thing! Speak with the Director of Nursing, regarding initiating the Medicaid applications, and start that now, to have it in process, so you won't be doing that while things get even more stressful. Just be with her as much as you can, and I wish you the best of luck in this very difficult time!
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1. Some of the meds hospice discontinued for my husband were added back in after it became apparent they were needed for his comfort. That is the criterion.
2. I agree with FF that starting the Medicaid process now is a good idea. Better to have it in the wings and never need it than to be scrambling at the last moment.
3. My husband was on hospice care at home. I got to know the hospice people who came into our home. I was also given a phone number to call anytime I had questions, 24/7. (I used it a couple of times.)
My mother was on hospice care in a nursing home. We only interacted with the hospice staff when they happened to be there when we were, but we did get to know them somewhat. I think I was given a card with a number to call, but I don't remember using it. We had both hospice and NH staff to deal with in person.

Who is the person you are waiting on? That is, is it a second-cousin Mom hasn't seen in five years, or her brother? It is ideal if the whole family can consent, unless decision by committee delays things unduly.

My stepdaughter works in an assisted living and recently one of her residents died. The entire facility loved this guy -- jovial, cooperative, witty, friendly, etc. My dear SD sees a lot of dying in her position. This one was particularly hard on her and on other staff because the family was waiting for "one more member" to sign off on hospice, and in meantime they saw this wonderful man suffering great pain. I hope your decision isn't delayed. And what will you do if that person says No?

Best wishes to your entire family in this stressful time.
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For question #1, I am not too familiar with the COPD meds, but your Mom would continue to get her oxygen. Hospice usually takes away all meds and in it place use only meds to keep the patient pain free and comfortable.

Question #2, Medicare pays for Hospice care [but will not pay for the facility]. For the facility I would suggest starting the Medicare application progress now so it will be ready to use. Hospice will bring in a floating mattress which is more comfortable then a regular mattress and it helps to reduce bed sores. Hospice will also bring in a geri-recliner only if the nurses/aides are able to move Mom from the bed to the recliner.

Question #3, Hospice usually works in a team. One day a Hospice nurse will come to get vital signs, etc., he/she will stay only a few minutes. Another day a Hospice Aide will come in to help your Mom with personal care, usually stays a hour or so. Another day a volunteer would come in to sit with your Mom and talk to her, read to her, etc. The amount of extra care could vary from one Hospice group to another.

My Mom had Hospice for three months and it was great having another set of ears/eyes watching over my Mom besides the wonderful nursing Staff at the long-term-care facility.
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