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DTXGAL Asked March 2017

Dad's doctors wont refer hospice.

My dad has lost about 35 lbs and tests show blood and everything are fine. He can barely walk, sleeps most of the time and stimulants or whatever they gave him never gave him back his appetite. In Dec 2015, he had gotten fitted for upper dentures and some teeth taken out. Once he received the dentures, they were bucked, painful and he couldn't eat so he started Ensures. He started rapidly losing weight. His girlfriend finally convinced him to get refitted but it had been months. They found pieces of teeth still left in his gums which caused the pain but the new dentures fit great. He could chew food but chose soft ones still and couldn't eat but a few bites. He literally drinks only a half an ensure, half his coffee (he has to have, he says), has no energy and his has trouble breathing trying to walk. He won't quit smoking either. He says he knows he has to force himself to eat but he said with no appetite that it's so hard. It's hurting all of us to watch him wither away when before these dentures, he was outside working on his yard, traveling, going to church, choir practice and bowling in a league once a week. My youngest brother lives with him but has to work to pay for food for dad and himself. It's an hour or so from my house and I have Dr appointments, husband's physical therapy twice a week and husband's business so it's hard to get out there. Dad's girlfriend lives 15 minutes away but also cares for an elderly 85 yr old lady from their church. The Dr's won't refer Hospice. They said he has to have a terminal illness for 6 months or 6 months to live before he can be referred. Dad has Medicare, so is there a way we can get help for him with a nurse coming by to check on him, make sure he's taking his meds, bathe him and chang his sheets? It's been so hard on my brother and he worries he may fall again. His last fall bruised one side of his head. Ive never been close to my dad. He is close to my three brothers but seeing him suffering like this is killing me. I've had to put off my cardiologist appointments because I was crying so much for a couple weeks worrying about my dad. Thank you for any advice you can give.

surprise Mar 2017
Hospice is wonderful - if there is a diagnosis of something that could kill him in 6 mos - COPD? - any hospice agency can look at his records and determine his eligibility using *their* doctor, not his. It sounds like "failure to thrive" as well as malpractice against the doc who pulled the teeth without follow up. Please get a second opinion here, from someone who does not know the first doc. Perhaps a geriatric specialist if he's elderly would be the best, and at a large hospital for the best service.

Shane1124 Mar 2017
If you have the resources you can hire a CNA to come in and give him a bath, change the sheets, etc.
Agree with Barb, what is his diagnosis re not being able to breathe? Why hospice?
If your father suffers a medical event (like a bad fall of some sort( and is hospitalized his PCP may order home care from an agency, but they won't keep coming after he is stable.
Sure, I would check with the VA for "aide and assistance" (which I am unfamiliar with) and your dad has to be basically indigent to get Medicaid.
Hope this all works out for you & your family!

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Sunnygirl1 Mar 2017
I'm so sorry to hear of your dad's decline. I can't imagine how painful that is for you and him. Will the doctor say WHEN he might have enough criteria to recommend Hospice? Have you tried just calling a Hospice and see what they say? Is it likely the doctor will change his mind soon or a different doctor would see things differently? I don't know much about Hospice. Maybe those who do will chime in here.

I might check with your county's counsel on aging or Social Services to see who accepts applications for the services he needs. You never know what state or county programs that might have something available. Also, maybe his church might step up with some help if they know there is need. I noticed you said he attended church regularly.

BarbBrooklyn Mar 2017
What is the cause of your dad's breathing problems? Has he been referred to someone for that?

Has dad ever had a swallow study? Could lack of swallowing ability be the culprit, not lack of appetite or denture issues?

In terms of crying about this, it's normal! It is sometimes called anticipatory grief. One of the most productive doctor appointments I ever had was one shortly after my mom had a stroke. I had a good cry, got good advice from the doctor and learned to let go a bit and take care of myself.

Might you consider seeing a counselor or therapist to help you sort these feelings out?

In terms of getting dad some in home care, will doctor write a script for those? Does dad qualify for Medicaid or for Veteran's benefits?

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