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My 71 yr old father died last night at the hospital. He was diagnosed with stage 4 melanoma in the Spring of 2018. I won’t detail the entire cancer journey in this post, but I wanted to discuss an alternative to hospice. My goal is to help other “newbies” out there facing similar end-time choices.


Dad had been living at a skilled nursing facility. Hospice had been recommended a few times by doctors within the last few weeks, however, we felt routine treatment was needed for palliative purposes such as blood transfusions. This week, dad asked to go to the hospital and was transported there by ambulance. Suffice to say his condition further declined and the attending physician recommended hospice. After some discussion, he later offered “comfort care” at the hospital. We were given the option of staying at the hospital for a few extra days under a hospice-like philosophy. We were able to discontinue most meds and introduce new meds to improve comfort and reduce pain. Note: a DNR, advanced directive, and POA was already in place. His final hours/ minutes of life ended as well as it could with me by his side - no regrets.


Prior to this experience, I had been under the impression that once we pushed the hospice “button”, dad would be discharged from the hospital and transported elsewhere. That is not the case and I wanted others out there with limited experience in this area to know that. If your terminal loved one finds themself in the hospital, you should know that hospitals can and do provide “comfort care” to dying patients instead of the burden of changing locations to a hospice setting. As many of you know, staying a little longer at the hospital allows for better care than being at a SNF.



In reference to his cancer journey with stage 4 melanoma, I will summarize that in a future post with the goal of helping others better comprehend what they might expect.



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So sorry for the loss of your dad. Thank you so much for sharing this information. It’s always helpful to learn from others on this forum.
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I’m sorry for the loss of your dad. I’m glad his passing was peaceful.
My mom also had pallitive care in the hospital as did my BIL.
A family friend was having hospice care at home. The family was overwhelmed the day he died, they called 911 and he went to the hospital where he died later that night. He was in pain at home. His MIL, a few years before went from a SNF to the hospital. She was a nurse and directed all her moves. They saw that was better for their family. So, I agree the hospital is an option that should be considered.
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It’s worth knowing that hospitals are very wary about taking on patients who will occupy a bed for many days, without actually needing the high level care that is the purpose of hospital. If the person is clearly at end of life and will die within a day or two, the situation is different. The patient can stay without disruption or intensive care, because it is in their best interests. I haven’t heard of patients being discharged when they are clearly in the process of dying very shortly.
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Im sorry for the loss of your dad, I certainly understand. And thank you for posting your information so others can understand there is help available for end of life situations. Take care of yourself.
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My mom died in hospital under the guise of comfort care. Unfortunately in my mom's case it should probably have been called something else. I was coerced into it my an overly aggressive on-call twit, oh, I mean doctor. Don't get me wrong, ultimately my mom was going to die very soon but I just did not like the way the whole thing was handled. I've told this story a few times on this forum so I won't bore anyone again with all the details.

I'm definitely not suggesting that Comfort Care is a bad option. Hopefully in most cases it's handled correctly and tenderly with everyone's best interests in mind, especially the patient. Sadly, in my mom's case it was a very unpleasant experience.

That's why proper communication between patient's family and the doctor's and staff at the hospital is vital. Lack of that and things can go haywire pretty fast.
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shad250 Feb 2, 2020
So sorry that you had a bad experience, but if insurance was paying, this is not surprising. Some may not know, but many hospitals want to do well by insurance meaning if there is no hope for the patient improving, they'll nudge loved ones into letting them go sooner, so as to save the insurance company money.
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Okhome I am so sorry for your loss. I should have said that first. My apologies.

I'm glad Comfort Care worked for you and your Dad.

((((HUGS))))
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You explained comfort care exactly. Stop some meds and add others to keep comfortable. Staff assists in passing as best that they can and usually it goes well. Sometimes something unexpected can happen but it is not frequent
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So sorry for your loss.

But what u describe is Hospice care. Meds are stopped and others given for comfort.

My GF had Hospice care (thats what her DH called it) in a hospital setting. This was a large hospital. In my area, there are no Hospice houses just for that purpose, Mom was already in LTC when Hospice was brought in. Not that it has never happened, but I have never heard of transporting people to LTC facilities just for Hospice care. Most Hospice in my area is done in the home.

And who pays for Comfort care. Hospice is paid by Medicare. Like said, hospitals usually want you in and out. Just wondering.
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pamzimmrrt Feb 2, 2020
Here in my area of MD there is a hospice house, called Klines,that is wonderful. My BFF had her husband moved there from the hospital to pass. It is private pay ( I believe) and like a house with a kitchen and LR/Game room for the family to use, and about 12 hospice beds. He was taken by ambu, and their experience was wonderful and peaceful. So maybe it depends on your state and or area?
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Please accept my sincere condolences. I have never heard of a hospital offering the comfort care you’ve described but I think it’s a wonderful option. I hope all hospitals will consider such care. Thank you for the information. And again, I am sorry for your loss.
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Joanne in my case I live in Canada and we have a government medical plan here that covers Comfort Care since it's done in a hospital.
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I'm so sorry for your loss. Hospital would want dad out as soon as he passed, since they don't want to be reminded of a life not saved, as but one reason, sad to say.
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worriedinCali Feb 2, 2020
Oh good grief! Must you do this? Hospitals do not rush the deceased out because they don’t want a reminder of a life not saved. Death Is part of the job, there are plenty of reminders of that they see in a daily basis.
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My sincere condolences for the loss of your father. Yesterday, my 89 y.o. aunt was tranferred from "comfort care" to hospice facility - at her own request ( she has no cognitive issues). She was very recently diagnosed with metastasized liver cancer. I honestly wasn't aware of in-hospital comfort care option until now. I believe it's the same as palliative care -? Similar to what 97yroldmom said in her post, my aunt is directing her care. I spoke to her this morning on the phone ( I'm 2,500 miles away). She sounded good, just tired. This is very hard. Love her as much as my late mother, her big sister.
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Such good information. I know when I worked in a hospital we often transferred patients to our skilled nursing floor for this very reason. I think this is most often done when death is imminent. Condolences on your loss, and so glad you could be with your Dad to the end.
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