_For hospice, there are 2 main tests: 1. The Functional Assessment Staging Test (FAST) Stages:
1. No difficulties; 2. Subjective forgetfulness; 3. Decreased job functioning and organizational capacity; 4. Difficulty with complex tasks and instrumental ADLs; 5. Requires supervision with ADLs; 6. Impaired ADLs, with incontinence; 7. A. Ability to speak limited to six words & B. Ability to speak limited to single word & C. Loss of ambulation & D. Inability to sit & E. Inability to smile & F. Inability to hold head up
2. The Mortality Risk Index Score (Mitchell). This seems to get used more: 1.9 Complete dependence with ADLs;
My mom went onto hospice in June. She is in a NH and shattered her hip. The first hospice group was less than great and I switched to a different hospice provider in August. The first group was assigned by the SW @ the NH as it was an immediate need situation. Hospice is totally Medicare paid for and so can be determined by the Medicare enrollee to which provided they want. Did the change and it was pretty seamless. So you can change the hospice group if need be.
MIL went to a free-standing hospice facility from a hospital discharge. She was there less than 2 weeks then passed away. The nursing staff was amazing and it was really the best situation for her to be in. Not all cities have free-standing hospice facilities. My mom's city does (an old women's & children's hospital is now one and run by Vitas). But my mom probably would never be transferred to it as her care level can be done @ the NH till the end. But if your hospice group has such a facility it can be often good for family to be able to use towards the very end as the pain medication monitoring can be done in these places if they have more serious diseases like cancers.
On the MD's - for NH the MD/medical director of the NH has to request hospice, then the hospice MD has to also sign off on the need. This is probably standard.
There are 2 different criteria for determining hospice: the FAST rating and the Mitchell score. I will do another post on those.
Hospice is done first on two 90 day periods, then renewed every 60 days. They can stay on hospice for years if they continue to qualify but can be removed if they get better. There is a lady @ my mom's NH who is in her 4th year on hospice!
We had Hospice come in for my stepfather he had a disease that slips my mind right now. They were God sent....to the very end. Lou Garrets disease I believe it was.
Dear Hernter, so sorry for your loss and so sorry for your bad experience. As with all businesses, there are good and bad. Everyone needs to research who they use for whatever it is they need help...doctors, in-home health care, rehab, hospice. God bless you for what you did for your Mom.
well it started out being okay, until they told me to start giving her morphine, cuz every morning she would cry she hurt but that went on for months before i got hospice to come in as her primary doctor stated she was at her end of life, never really knew what was wrong as i lived in az and my brothers where taking care of her and she was going down hill fast,so i moved to wa. to take care of her,it was a nightmare as my brothers never gave her meds or ever took her to the doc, i had to force my brother to take her to the emergency thank god i pushed it, she had 3 broken ribs and had 2 blood transfusuions.from their she went into a nursing home, then she fail and broke her hip then she had surgery doc didnt think she would make it but she was a fighter , then my uncle had poa he and his wife told me she could never come home, i figured their were bs i got my mom home and i took care of her by my self until i was so wore out i got in home care to help then finally hospice so i gave my mother 1 yr of quality life and she was on her meds and seeing all her doctors.guess i wasnt prepared for her dying in my arms and the way hospice acted like it was nothing cuz i would call them and ask questions cuz i never went through any of this and hospice was never their to tell me she is dying and this is what to expect, i did everything i could for my mom i was their day and night, when i asked hospice to come check her out they said they had their prioritys they had to go to another client it would be like 2 hrs i said please my moms not right shes breathing weird, they never showed so 2 seconds later my mom passed so i called them back and they came in a few min they where their, i was numb,hurt, angry. Its been 2 years this jan my moms been gone and i wonder if i did things different if she would of had it easier. but from day one hospice was just going the the motions ,no compasion, and while my mom was in reciept care her wedding rings where stolen. and she hadnt eaten since the day they took her I HAVE NOTHING GOOD TO SAY ABOUT HOSPICE...................PERIOD.......
The best part is Hospice help is available not just for end of life. But when certain criteria is met. She/he can stay in the assisted living home and get hospice help (not for dying) and not have to go to a nursing home.
We were blessed when Hospice came to help when my dad was near death. Peggy from Chesapeake Hospice came to our my parents' home and talked to my mom, one of y sisters and I and answered all of our questions and helped us to understand the dying process. She was wonderful to our dad and helped us all to navigate the unknown territory thrust upon us. I would highly recommend giving Hospice a chance to help all the parties involved as it is not just the patient but the whole family that need intervention in such an emotional time. Peggy was in our lives for a very short time but gave us all the support we needed. Bless you and your family as you embark on this journey.
My father was on hospice for about the last month of his life. He died at home peacefully January of this year. They were very knowledgable in the whole dying process and helped us throughout that time. A priest even came and prayed with my mother and gave my father his last rites.
Hospice is a good tool. My husband spent the last 13 days there. He was in the local hospice house which was lovely. It's too bad our loved ones can't stay there longer. Hospice is available in your home or at a facility, but I liked their own house best because there weren't as many people involved...I could stay as long as I wanted, come and go any time; it was a great relief. After months of pain, my husband was comfortable and well cared for. I certainly would recommend it.
BTW, my mom was eating when she first arrived at the hospice center.... for the first two days. She was living with me in my home and I did not want her to die in my house....too sad for me....and I had already reached the point that I didn't have it in me to go without sleep any more. It was the best decision for me.
My mom was admitted to a hospice center directly from the hospital to live out the last week of her life. I had already heard good things about it from other friends. It was an absolute blessing. The knowledge those women had in the dying process helped me tremendously. I had sisters come in from out of town and they stayed at the facility the whole time. The facility had bathrooms in each room for the families, they provided pillows and mats for overnight, and a full kitchen for the family members to use. The nurses were angels and treated their patients with the upmost respect. My mom was even garbed in a real gown with satin or ribbons or lace as opposed to an old hospital gown. To this day, I remember the sincere heartfelt HUG I got from the nurse that confirmed my mom's passing. Maybe we are just lucky in this town to have this facility, but if I could make reservations for myself, I would.
Moonbeam, I just called them, the nurse came out and said my mom was eligible. But it might have to be approved by a doctor. My mom has late stage dementia, not a terminal illness, but she qualifies.
Definately check out a few in your area and if possible talk to people who have used the service. Hospice can be wonderful and having someone avaliable to you to help is very comforting. When my dad was sick we had a visiting nurse come and when he made the decision to stop fighting the nurse we had set us up with the hospice side of her organization. Having never done any of this we just went along with it. I had heard great stories about how much hospice helps and how comforting it is to have them there so we were happy to welcome them into the home to help us. The one we used was not like that, they seemed distant and really did nothing to help my mom through the process of losing her sole mate. We have no regrets though because luckily for us dad did not suffer and his end of life journey was short. Between myself and my brothers we were able to take care of dad so all hospice did was check him a few times a week. We were a little taken aback though when the nurse came the morning he passed away because there was no compassion for my mom or any of us, she came in, looked at him, checked his pulse and said yes he is gone, really we knew that already. She then sat at the table for an hour filling out paperwork and not once did she converse with any of us. The funeral director showed my mom more compassion and help than the hospice nurse did. If and when we ever need hospice again we will check out more than one. Hospice can be wonderful and for the family the right one can offer compassion and be an invaluable help to the family so make sure you are comfortable with whomever you chose.
We are using a program called hope pace, not sure what areas they cover but it is a good day program, they offer day respite up to two days per week, five hours per day. I am looking for a weekend respite , one weekend per month if anyone knows of a reputable place.
My comment: There are a lot of different hospice to choose from and taking the time to research at least three is a good idea. The main goal is to find the one that best fits your families needs. I network with a couple of hospices here in San Diego and I know each company has it's struggles. Interview, question, pray and visit the hospice you are interested in using. Hope it helped
Yes, I've signed 3 people into 3 different hospice programs. All were wonderful. One used it for 1 week, 1 for 3 months and one for 6 1/2 months. In my opinion, the earlier the better. I agee with the other postings, find out if more than one serves your area and what it offers. Then consider your Mom's needs. The extra help is wonderful. All 3 of the ones I used offered an aide for 2 hours, 5 days a week. Great to get that help (even though one of my 3 was in assisted living!). They assess, arrange for equipment and meds, and (at least the ones I used) are only a phone call away 24 hours a day. God bless them all!
When understanding that hospice is about HOPE, and honoring patients’ choices about how they want to live their final days, about providing comfort and managing pain and symptoms associated with an illness, it makes sense to take advantage of the services hospice offers at the earliest appropriate time.
We used hospice for the last three months of my dad's life. They were very good. What I didn't understand was that depending on where you live, there are a number of different hospice groups. So ask questions about their services and compare if you have more than one choice. My dad wasn't in pain and wasn't religious, so they didn't need to provide him pain management or pastoral care. But it would have been available if he needed it.
My husband was only on hospice 5 weeks, in our home, but the care was amazing. I highly recommend having hospice involved in end-of-life situations ... the sooner the better!
my dad is on hospice care, and they are amazing. I have an aide that comes twice a week that shaves and showers my dad and the nurse comes twice a week to check vitals, answer any concerns I may have and makes sure he has his meds. they also provide pull ups (dad is incontinent) and bed mats. I can get respite care for 5 days every 3 months and that really helps recharge my batteries, they also have volunteers that will come and sit so I can go to the store or Dr.s appointment but I haven't used that service. I can call on them any time day or night if dad is having an issue that is worrisome for me and they will come and check on him, I couldn't do it without them. so yes if you have a choice of hospice groups ask around for referrals. Best of all medicare covers the cost and I never see a bill
I used it for both of my parents and our local hospice was amazing. I kind of got my parents back for awhile after their pain was better controlled, and their deaths were dignified and pain free. My family knows that hospice care is what I want under such circumstances.
Not all hospices are equal, but most are good and many amazing. If you have a choice, as for referrals. Take care, Carol
1. The
Functional Assessment Staging Test (FAST)
Stages:
1. No difficulties;
2. Subjective forgetfulness;
3. Decreased job functioning and organizational capacity;
4. Difficulty with complex tasks and instrumental ADLs;
5. Requires supervision with ADLs;
6. Impaired ADLs, with incontinence;
7. A. Ability to speak limited to six words & B. Ability to speak limited to single word
& C. Loss of ambulation
& D. Inability to sit & E. Inability to smile &
F. Inability to hold head up
2. The Mortality Risk Index Score (Mitchell). This seems to get used more:
1.9 Complete dependence with ADLs;
1.9 Male gender;
1.7 Cancer;
1.6 Congestive heart failure;
1.5 Bowel incontinence;
1.6 O2 therapy needed w/in 14 days;
1.5 Shortness of breath;
1.5 less than 25% of food eaten at most meals;
1.5 Unstable medical condition;
1.5 Bedfast;
1.4 Age over 83 years;
1.4 Not awake most of the day. You add them up & get
risk estimate of death within 6 months
(their Mitchell score):
Score Risk %
0 8.9
1-2 10.8
3-5 23.2
6-8 40.4
9-11 57.0
12 + 70.0
The score can change over time & so they can be removed from hospice.
MIL went to a free-standing hospice facility from a hospital discharge. She was there less than 2 weeks then passed away. The nursing staff was amazing and it was really the best situation for her to be in. Not all cities have free-standing hospice facilities. My mom's city does (an old women's & children's hospital is now one and run by Vitas). But my mom probably would never be transferred to it as her care level can be done @ the NH till the end. But if your hospice group has such a facility it can be often good for family to be able to use towards the very end as the pain medication monitoring can be done in these places if they have more serious diseases like cancers.
On the MD's - for NH the MD/medical director of the NH has to request hospice, then the hospice MD has to also sign off on the need. This is probably standard.
There are 2 different criteria for determining hospice: the FAST rating and the Mitchell score. I will do another post on those.
Hospice is done first on two 90 day periods, then renewed every 60 days. They can stay on hospice for years if they continue to qualify but can be removed if they get better. There is a lady @ my mom's NH who is in her 4th year on hospice!
patients’ choices about how they want to live their final days, about providing comfort and managing pain and symptoms associated with an illness, it makes sense to take advantage of the services hospice offers at the earliest appropriate time.
I can get respite care for 5 days every 3 months and that really helps recharge my batteries, they also have volunteers that will come and sit so I can go to the store or Dr.s appointment but I haven't used that service. I can call on them any time day or night if dad is having an issue that is worrisome for me and they will come and check on him, I couldn't do it without them. so yes if you have a choice of hospice groups ask around for referrals.
Best of all medicare covers the cost and I never see a bill
Not all hospices are equal, but most are good and many amazing. If you have a choice, as for referrals.
Take care,
Carol