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I've read that Hospice can be called in to assist with patient who is residing in an Assisted Living facility. Does anyone know how that works? I'm trying to envision it.

My cousin's not doing well. The ALF team and I met yesterday. I am exploring Palliative care now. Depending on some pending tests, I'll know more, but want to learn what is available when the time comes and Hopsice might be an option.

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Glad you met with the team, it sounds like they will work with each other.
Hospice is fully covered by Medicare, they take over the medication orders, you work with the Hospice MD instead of your primary.
With Hospice, there are no 911 calls, you call the Hospice Nurse. There are no more surgeries, no more chemo, nothing painful. Pure comfort medication. Medicare now requires proof (test results) showing the patient has less than six months life expectancy. Once approved, you meet with the team and you work out the fine details. They are wonderful people.
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Thanks for the information. I'm exploring all our options.

We have reviewed my cousin's medication list and are making some adjustments. Hopefully, that will help, but I have to be realistic. I fear she has Failure to Thrive. She has all those symptoms. No one used those words, but I found it online. We don't know if medication can help it.

Cancer is now strongly suspected. Further tests should reveal the answer to that. The dementia is getting worse each day too. Things are just building up and it's not good.

She loves the ALF (cries to return when she goes to doctor appts.) and our plan is to keep her there as long as possible. She can still get up and down and walk with a walker, but is sleeping a lot, refusing meds, care, etc. She is steadily losing weight, lacks energy, but at times has bursts of energy for a short while.

The team members have seen this before in residents. I could tell, so I asked, how long does she have. They didn't answer it, but they weren't shocked either, so it told me a lot.
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My father lived in an assisted living facility with services from hospice during the last few months of his life. At first the hospice RN came weekly, with visits from a hospice CNA twice a week to bathe and shave him. As he became weaker, the RN visited more often until, at the end, he had someone at his side almost all the time. When he died, both my mother and a nurse were with him; the nurse stayed with my mother for several hours, until she decided she preferred to be alone. We were grateful to the ALF for cooperating and to hospice for their kindness.
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Mother is currently in AL with Hospice. It is a wonderful service that has helped me and my mother!
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Hi Sunnygirl1 --

My aunt is currently under hospice care, in her own home, but she does not have a specific disease diagnosis. She is very elderly (108), and her diagnosis is "debility" -- which is similar to what "failure to thrive" would be for a baby/child.
When we first started the process of finding out about hospice for her, she was eating less, having much less energy, sleeping more, etc., and did have some early dementia. We thought that hospice would not admit her without a clear disease, but we were told, by hospice, that "debility" would apply in a case like hers.

Hospice care has turned out to be excellent for my aunt - we are very grateful to them, and happy that she can be kept safe and comfortable in her own home.

Good luck to you!
Sheryl
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It's nice to hear such good report about hospice. Thank you for sharing the stories of how your loved ones passed.

I have considered taking my cousin back to her house, but there is no one there to be with her at night. I'm not sure how much time a hospice team can spend in the home. My cousin lived there alone. I am the only one involved and the only one who could stay there at all. I run my own business and though I would love to be with her around the clock, it's not possible for me to do that indefinitely. Besides, she now considers the ALF home and going to her home may not be comforting to her. I guess I'll cross that bridge when I get there.
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Also, Sunnygirl --- By having hospice come in at the ALF, your mother or father is doubly or triply benefitted. The ALF goes on providing clean sheets, clean rooms, meals (if your parent can eat), some personal care, and watchful eyes 24/7, while the hospice staff provide the trained end-of-life attention. So much better and less unsettling for your parent than trying to piece together 24/7 care with an assortment of family members and paid caregivers.
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My mthr has been on hospice for a month now in her Memory Care ALF where she has lived for 2 years. She has dementia stage 7b, total incontinence, limited speech, used to walk with a walker but has forgotten she has one and has been falling. She also seems to be anemic, which probably points to her cancer returning. However, more than a year ago she said she did not want to know if she has cancer and we stopped taking her to the oncologist.

Hospice is providing care for 7 patients at her ALF home. She gets an aide in the morning who washes and dresses her and takes her to breakfast. In the evening, she is changed and put to bed. The nurse manages the med order from the doc and has taken her off sedatives and onto a psych drug which tempers the electrical activity in her brain, so she is more alert and more calm. Hospice orders her disposable underwear, bed pads, gloves, privates wash, and other things, and that is paid for since it is medically necessary. I have 2 chaplains to talk to, and the social worker was willing to help us find financial aid if she needed it.

Most importantly, the social worker had us make final arrangements so we know what will happen when the day comes. Mthr wanted to be donated to science many years ago, but then the med school close by started charging to take bodies and she did not know what to do. I told the social worker what mthr had wanted. She told us about a number of places, for profit and not, and we chose the best fit. This particular place will cremate the ashes and return them, or scatter them over the ocean. Since mthr loved the oceans more than anything, we knew that is what she would want. She will finally be able to make that Pacific expedition she always regretted not attending, and that makes me feel really awesome! Hospice is empowering.
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(the body donation program is free if the person is accepted, and cremation and return or scattering is free too).
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Surprise, how long with the Hospice team stay? I have read the doctor has to estimate the life expectancy to be now more than 6 months, but the Hospice team can stay longer. I am anticipating something like your mom has set up. This would keep my cousin where she is comfortable and provide her the most support.

I hope to know more after more tests are in and the cancer diagnosis is conformed.
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