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My Mom has dementia and has declined steadily the last five months. We have been taking her monthly to her dr appts, but it is getting harder to transport her and get her back in the house.


I am wondering what would happen next if she has an appointment, but we are not able to get her there if she is too weak. Can I insist that a nurse come to evaluate her needs? We would call an ambulance if it came to that, but is there a way she can be checked at home? Would we need hospice then?


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I have noticed in my reading on the site that some areas have access to palliative home care if she is not yet ready for hospice. It seems to be provided by the same agencies that offer hospice care, I'm not sure how it is funded though. You should ask your doctor if this option is available for you.
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Sher, you have a few options.

1. Is it her mobility that's declining, her cognitive functions, and/or both? Has any of her doctors D'x'ed her as end stage?

2. There are professional as well as public transit options available.

3. Contact the closest public transit company in your area and ask if they have paratransit options. These are typically in smaller buses equipped with wheelchair accommodations. They are also sometimes point to point specific, so they can come directly to your door and assist with ingress and egress.

4. There are other commercial companies that provide what's sometimes known as "ambulette" service; it's like the public paratransit but multiple times more expensive.

5. Investigate getting a ramp installed for easier wheelchair ingress and egress. If there's an attached garage, sacrificing one space to install an indoor ramp is preferable to a ramp from the front door to the driveway. You will have to comply with local code requirements though on the slope ratio, so check with your community's building/code department.
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I think it would be time for hospice if your mom isn't able to get out to her Dr.'s appointments. A hospice nurse would oversee your mom's care and that nurse works directly with a Dr. The Dr. wouldn't come to the home but the nurse would follow the Dr.'s orders.
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