Does anyone have advise about getting the doctor to sign off on hospice?

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My husband and I are caring for his 96 year old grandmother. She has dementia and has fallen three times in the past week. The first fall resulted in 5 staples to the back of her head. I have stopped working to be home with her in our apartment but I could use some help. I have four very busy kids and my husband has long work hours with only Monday's off sometimes. This past week has been so difficult after the fall her confusion got even worse she had no idea . screen door and her worker. She also went 40 hours straight with no sleep which meant I also couldn't sleep, she was hallucinating and trying to reach for thing that weren't there. I called her neurologist and he suggested that I watch her better I told the arrogant ass that not even Superman could have eyes on her every second that I do have to sleep and do laundry sometimes. He finally prescribed her Xanax now she is resting but that is still not the solution. Do I confront her another doctor about suggesting hospice?

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We only had Hospice for I believe 4 or 5 weeks before they suggested respite. Ours was for 5 days, but some pay for as long as 10. Hospice pays for it. I even checked out a couple of places myself and I chose which one she stayed in. My cousin and I still went to visit her everyday and truthfully for us the house seemed kind of empty without her. My sister doesn't come over much and does not help at all. She wants her in a nursing home. But to me if you have the right support system they should be home with the people that love them and who they love. Hospice brings in all the equipment you need. Bed, wheelchair, oxygen, etc. I thank god everyday they sent them to me. They even have a doctor that will come to your house. With our Hospice we can do respite whenever we think we need a rest, once a month or every few months. Your choice. They also help us save money we don't have by supplying almost anything and everything she will need. Our prayers are with you and your family.
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to needinghelp08; kaitlyn's and several of the others regarding calling and checking directly with hospice agencies in your area is a good idea. i know there are several Hospice agencies in our area. Hospice came in for my husband and even though with the help of an aide or both an aide and a hoyer lift, we could get him into a chair; (he was a stroke/alheizmer's patient), he still got taken care of better than what I could do myself. Hospice is one of the greatest blessings that ever happened to me with not only my husband, but also with my mom. He also had a real hard time sleeping at night, and Hospice got on board and wouldn't give up till we found what we saw worked and finally got him sleeping at night. And yes, some do have respite and volunteers. Make sure you ask each individual Hospice agency about how long respite is, and also how long your husband will have to be a client of theirs before they can set you up for a break with respite care. Most of them are I think at least 45 days or so. I may be off bit on that. Anyways, hope this will help you out. So, if it's okay, I'd like to say a quick prayer for you.Lord Jesus, I know this situation is in Your Hands, and so does needinghelp08. Just like her screen name says Lord, needinghelp. So, I just want to thank You for the help you are sending her, and for making the connections that only You know will bring her closer to you. you already have Lord, because this site has brought many closer to You. Keep wrappin Your arms around her and give her sweet sleep according to your Word. I ask this Father in Jesus name. amen
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My mother has dementia and the last time she went to the hospital she had a toxic blood infection, UT infection and CHF. I sent her to a nursing home where they were suppose to get her medication in order. It was suppose to be from 7 to 14 days, she was sent home after 5 days with all this stuff wrong with her. The toxic blood in infection was cause from her being left in her own was threw a bed sore. The doctors said people her age usually doesn't make it through, but she did. My mom is on hospice now. She is bed ridden, but and aid come M-F to bath and help use with anything else we may need. A nurse come 2 times a week and the Doctor come if we need her. They also provide pads, diapers, lotions and bath supplies as well as her meds. She had 8 meds she takes and we only pay for 4, plus they just brought her another med for a cold. They really do help and it's not just for terminal. My mom is a strong woman and a long way from dying ( I hope to god). Just talk to a good doctor (that has a heart) and see if he or she can do anything for you. We live in Texas and the hospice we have has become like part of the family. They are a god send.. I choose to take care of her at home and my sister wants her in a nursing home, but I refuse to let her died alone like our dad did. Talk to some of the hospice to see what can be done and keep talking to the doctor. Now the aid only comes in from 30 to 45 minutes, but just bathing mom and changing her bedding helps us a whole lot. Just keep bugging and pushing and maybe someone will listen to you. God bless and I hope everything works out for you and your family. You need the help with her, kids and house.
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Nanfran: There is a big difference between allowing someone to eat what they feel they need and starving them. Did you ever have a discussion with your husband before he became so ill regarding what kind of "heroic measures" he would want if he were as ill as he is at this time? My five siblings and I could not agree on what to do for our father during the last 2 months of his life when he could not longer participate in a discussion concerning his wishes. Fortunately, a Living Will that he had written ten years before was subsequently found in which he was very specific about not wanting any treatment except pain medication if he was severely impaired with no hope of recovery. His Living Will was very specific about saying that he did not want a feeding tube, oxygen or IV medication other than pain meds. Since my father was a doctor, he knew exactly what he was requesting. You should know that people who have gone on hunger strikes (often for political reasons) have later reported that there was no pain or discomfort associated with not eating. However, feeding tubes do cause pain and discomfort. If your husband had some reasonable hope of recovery, then a feeding tube could be justified but since that isn't the case, all you are doing is causing him more suffering. It is so very hard to stand by and do nothing but that is often the most humane thing to do.
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Thank you all for your help. The doctor suggested taking her off the Xanox as he says it could be toxic to someone at her age. He has also advised that I contact social services at our local hospital.

As far as the family situation my husband and I are the ONLY family that has stepped up to help her. Her son is an a$$ which hasn't even called to check on her in the past two years. I will do everything I can to keep her with us and her 4 great grandchildren. She seems to get more anxious when she doesn't have hear my voice. She won't ask anyone else in the house for help.

Thanks again to everyone hoping the ss at the hospital will direct me in the right direction.
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Needinghelp, I had, and canceled Hospice. I've heard it can be great at the end of life, but it wasnt for me at this time. My Mom cannot walk and has severe dementia. I needed help with her each morning to get her up and washed and dressed. After 2 Hospice Aides quit, they told me she is a 2 person assist and they are only supplemental help. They then said they had no more Aides until 2pm, which is when Mom naps and they knew it. My Moms soaked when she wakes up, I need help mornings and they promised it or I wouldnt have gone through the 4.5 hour intake process. After I had signed up they told me dont ever call an ambulance or take her to the Hospital because it wont be covered through her insurance anymore. I was to call them only! Long story short, I canceled them on day 3.
I hired help through care (dot) com online. Its hard to find someone good and you might go through many, but its worth it. I use my moms SS to pay for it, and her supplies. I suggest putting locks high on your doors before she leaves on you. Xanax can make them unsteady on their feet, which isnt good. My Moms Dr put her on depakote and it was a lifesaver for my mom when she went thru that stage, so maybe ask about that so she will sleep at least. Hang in there, after all, shes 96 and its not her fault. I just believe in the golden rule and do my best, my Moms 91 and my husband helps me change her everynight before he bedtime, hes a saint and works fulltime too. I left my job to take care of her and I dont regret it.
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Sorry about the above---I meant her!
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It sounds like the others have answered your questions very well. I have a few things to add---hospice is NOT 24 hour care for the most part. Some hospices have a palliative care facility, if that is what you were thinking of doing--putting him in one of those? It sounds like you may need 24 hour care, and hospice does not provide that. Hospice may be able to adjust his meds so that he can sleep through the night, and when he is in crisis mode, a hospice nurse can do some continuous care until his symptoms are resolved. They also have a program called respite where they can put him in a nursing facility for a few days so you can get a break. Hospice, though, is generally not 24 hour care. If you need that, you might want to hire a caregiver, even just at night. If that is too pricey, and you can prove you cannot afford it, you may be able to get medicaid and they will pay for a nursing home. If you would really like to keep him at home, then there may be other programs in your state or city that would provide some caregiver relief. If you talk to your local hospice social worker, they will have resources for you in your area.
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Hospice care is intended for people with 6 months or less to live if the disease runs its normal course
You can get hospice care for two 90-day benefit periods, followed by an unlimited number of 60-day benefit periods
A benefit period starts the day you begin to get hospice care and it ends when your 90-day or 60-day period ends
You have the right to change providers only once during each benefit period
At the start of each period, the hospice medical director or other hospice doctor must recertify that you’re terminally ill, so you can continue to get hospice care
If you live longer than 6 months, you can still get hospice care, as long as the hospice medical director or other hospice doctor recertifies that you're terminally ill
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As a nurse, it sounds like she has a concussion since she hit her head and now is experiencing some bizarre symptoms. Get her to a psychiatrist who can diagnose any mental illness she may have had previously undiagnosed because not sleeping for 40 hrs. sounds like a psychotic manic cycle. The brain pumps so much norepinephrine and serotonin in the cells, they become overly excited and it is like she is on speed, but a natural one. I also suggest, just for the time being while you sort out her medical condition, you have someone stay with you (night duty nurse) so you can rest. You do not say why you have four "busy kids" living with you as a mother-in-law who is 96 yrs. has got to have a son who is in his 70s or 60s. Are these grandchildren? In any event, her condition is not normal, and the best advice I can give you is to seek another second opinion. Do it now so you can sleep and so can she! My best wishes.
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