Mom qualifies for a team of helpers from Hospice, but I can't shake the feeling that this isn't the best thing right now. Any advice?

To get back to Hospice, the pro is better meds. Hospice is able for some reason to dispense "addictive" medications to make the patient comfortable, where the family MD gets red flagged for it. Hospice sends you RN's at least weekly and they have a hotline to an MD; like old fashioned house calls. Hospice is fully covered by Medicare. No hidden charges.
The cons: the word itself "Hospice". Patients say NO as if it would somehow put off the inevitable. Family members think it is euthanasia. It is NOT about killing the patient, it's about removing fear and pain. It's about no more 911 calls, it's about no more rush to the ER. It's about taking time to say goodbye and not living in fear.

cadams, if you think that there are ways in which your mother can get better (as opposed to simply being more comfortable and happier) then perhaps she is not ready for Hospice.

Know that you can drop out of Hospice care at any time. If she developes something new that you think should be treated more aggressively than is hospice policy you can simply withdraw before starting the treatment.

Statistically, hospice does not shorten lives. There have been studies (published on this site) that show persons in similar situations live a little longer on hospice than those who are not on hospice.

My husband was not going to "get better" from his congestive heart failure or from his dementia. My mother is not going to "get better" from her broken hip or her arthritis or her dementia. The hospice care was/is to see that they feel better -- or as good as they possibly can -- as long as they live. They matter to the very end. They don't just "monitor" patients on their way to death, they proactively make that journey more comfortable for all concerned. As a small detail, my husband was getting very bothered by his constant drooling. The nurse immediately came up with a solution that worked great. It didn't cure the root cause -- the dementia -- but it increased his comfort. My mother is having trouble sleeping. The hospice nurse is able to prescribe a sleeping aid and to immediately respond to family observations. We are not waiting to get a message to a doctor and a call back. Everything is streamlined to get immediate action.

My mother is improving more than expected (I think in part because of the extra attention she now has) and it is possible she will leave hospice if she continues to improve, and then go back on it later.

Hospice is definitely a program for persons in the final leg of their life journey. (Obviously that determination can't always be accurate.) If you don't feel your mother is at that point, you may want to defer consideration of hospice to a later time. But if she is near the end I don't think you need fear that hospice will hasten her death.

My husband was on hospice in our home. My mother is now on hospice care in the Nursing Home.

I have nothing but positive, encouraging things to say about both experiences.

It is intended for persons who have a life expectancy of 6 months or less, but obviously no one can predict that length of time precisely. Your mother probably qualifies because of the sudden weight loss. My mother qualifies because at 93 she broke her hip and has dementia. That combination puts her in the statistical category of persons who typically die within 6 months of the hip break. I thought it made a lot of sense to take advantage of what she was eligible for. The nursing home staff seems to be working well with the hospice workers and appreciate more helping hands.

tried, I ache for you, because you really have hit a brick wall if the judge has ruled that brother is in charge. You really are stuck with hoping brother cares enough to keep mom comfortable. It probably does make sense not to put her through eye exams if her eyes do not hurt her; if she has heartburn she should get the GERD med, but occasionally people get stomachaches FROM those meds if used for a long time. My mom absolutely needed hers not to ever stop though, or she'd have terrible pain and be unable to lay down, due to a hiatal hernia that she was not a surgical candidate for. If she is eating and not complaining of toothaches that is probably OK too. We took my mom out to a dentist a couple times just a few months before she passed because she did have pain and wanted it treated. If you are allowed to visit her you could see if she is having pain, and they are probably giving routine pain medications. I was in charge of my mom and would have hated it if I had no say - I insisted she stay on her Sinemet because it helped her function better and quality of life, even though that would not have been covered apparently I said we'd pay for it...but that said,there is a time to cut way back on medical interventions, and at the very end she was having a hard time swallowing pills and I wondered about backing off...but it turned out that was actually just about the end. I have to say that I don't necessarily think the goal of any hospice stay should be for death to happen as quickly as possible, but I don't think that's what's going on here. A bruise on the head is probably (not necessarily- unless you don't mean a bruise but a subdural hematoma - they would have had to do a CT scan to see that though) not directly related to being unable to rouse a week later.

So you see what I'm saying - my heart goes out because this is awful for you, but it may well be that brother and staff are not just wantonly making bad decisions and feel terribly attacked and accused and defensive. This is a time of high emotions for everyone. If you really have been told "no" by a judge in those firmest possible terms, you really have done all you can on the medical care issues; and you should do what you can non-medically to be with Mom and make her time as pleasant as you can.

id ask them to refer to themselves as " home care " since every mention of the term " hospice " is a reminder to the patient of impending decline and death . they can be very helpful to you but beware of the fact that their quality of employees is sometimes much less than top rung , and dont let them bully you or your parent . if they do , take it up with family doc . they are reporting to him and you can do the same .. ask them to call ahead even if only by a few minutes. its basic respect and common sense but you might have to remind them .. always ask the patient if they feel like seeing the visitor today . this leaves the patient in control and is a reminder to hospice who is in control -- the patient.. the patient must be led to believe that they are in control or extreme agitation will result ..
let them operate unimpeded as long as they act like professionals , show your teeth if they cross your line in the sand ..
all costs should be medicare covered .

Check the rules and regs and the philosophy carefully. Hospice will sometimes not cover meds whose purpose is to extend or improve life other than pain relief. It also may mean limitations on any rehab services or getting Medicare inpatient subacute rehab days. For my mom it was worth it just to not have to have her back to acute hospital care. But she really was dying of a bad heart they could not fix. Hope you find some good help in any way that truly gives you and your mom some good times together for as long as possible!

Hospice also has volunteers that will come in and stay for couple hours so you can run errands or whatever. As for respite care. With my mil they are taking her for a week during 4th because with our business I have to be there to work cause that's where we make our money. So without the help of hospice during that week we might as well just shut the doors for good. And also the people who have come here to our home are the kindest and helpful people I've ever met. They know what families are going through and they adapt to every different families needs. I've already made my mind up that they are being left a donation in future from us. I have. Or come across any hidden fees. In fact they cover things that I couldn't believe. Like meds and briefs hosp. Bed wheelchair Ect. Awesome people. Mom was very spiritual. So they sent out a man to pray with her. She was happy big smile I haven't seen In long time. I'm not all that religious but to see mom that happy he is welcome here anytime.

I cared for my father for 4 1/2 years, in my home, while he suffered from Alzheimer's disease. I had Hospice care for 10 months, and I interacted with the Clinical Liason, Aids, Nurses, Nurse Practicioners, Physicians, Social Workers, and Chaplains. I have to say that admitting him into Hospice care was the absolute best thing I could have done. I have NEVER met such a compassionate, available, patient, and informative group of people in my life. The entire team assisted not only my dad, but my entire family in dealing with grief, fear, and assuring me that I was doing everything I could to make his time here as comfortable as possible. I am so grateful to the team of healthcare professionals that guided my entire family through the difficult journey of losing someone I loved so dearly.

cadams, if you are not sure, don't do it. If you think she can get better, don't do it. When the day comes that you see her spiraling downward and she can't eat, swallow meds or drink anything and you KNOW death is near, you call Hospice. She will get great comfort meds, nothing else. No calcium shots, no calls to 911, no office visits, no rehab. Just comfort. Not until you KNOW.

dusty , a doc has to deem you 6 months or less left to live to qualify for hospice but in many cases such as heart failure such a prediction is spotty at best . i think i see elder medicine changing before my eyes right now. aunt edna left a physical rehab after a weeklong hospital stay with ' home care ' hot on her heels . it appears to be the same services that were once called hospice. these people came from the rehab place . much nicer people than my previous experience . i think theyre here because with ednas daughter aging and not in the best health herself it appeared that the family carers could use some help .
same thing happened with aps again as in my moms case -- they contact poa and threaten them in advance -- just to keep them on their toes . crazy policy but it works and americans are some common sense people . if it works , we want a boat load of it and we want it NOW .. lol