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So mom's hospice nurse can't seem to set or keep to a real schedule with respect to in-home visits. In the beginning (Feb 2020), we set a schedule for Tuesday mornings. That worked for about 3 wks then covid hit and we switched to virtual visits. Since July, in-home visits have resumed.


Here's the issue/irritation: when we were doing virtual visits she had a bad habit of reaching out 10 min before wanting to do a visit. Because it was virtual I would just drop what I was doing for the sake of getting it done. Now that we are doing in-person visits again, she has a bad habit of calling and wanting to drop by in 30 min or less. WTH?


I'm a very organized person and like to plan my week/days in advance as much as possible. So is it wrong for me to demand/expect a schedule with respect to visits? I'm the sole caregiver for my mom and I feel like she's not respecting me or my limited time.


Any recommendations on how to approach this with her?

Hi all!

I requested a new nurse today. I've had enough. The last straw was when she blew me off about the flu shot and never gave me a call to discuss the recertification process....something I had been asking about for weeks.
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Reply to Nurturbynature
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Hello Everyone,

Sorry for the delay but here's an update on the situation: I spoke with the nurse and firmly explained that I needed a scheduled day of the week for my own organization and consideration for my mother. I DID NOT attempt to nail down a time because I know that's impossible in this line of work.

She seemed to understand and things have been good so far. Hopefully we can continue this relationship, if not, I will be getting another nurse and or company.

Thanks for everyone's input.
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NobodyGetsIt Sep 8, 2020
Thanks for the update "Nurturbynature," and like you said hopefully, you can continue to have an improved relationship going forward!
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Ask to speak to her supervisor.
Contact the head of the facility or if needed, above that (a person on the Board of Directors). I had a ... disheartening experience with Hospice 'grief counseling' services. In essence, I was put off and/or counselor didn't call me. I wrote to the head of the department and while a bit 'late' got VIP treatment. Really 'treatment'. I met with the head of the counseling dept for a few grief sessions. And, they profusely apologized.
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Reply to TouchMatters
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OPs last post was 8/23 I wonder if it all worked out?
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NobodyGetsIt Sep 3, 2020
"JoAnn29,"

I wondered the same thing. I think that is the hardest part about being on a forum. Most the time we don't get to know how things turned out!
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I was a Homecare RN and would give my client a two hour window of when I would arrive. I could never say I’d be there at a certain time unless it was my first case of the day because God knows an issue would arise and there goes my schedule.
As stated in other posts here, a nurse does not know what can happen during a home visit and needs flexibility. The two hour window worked for me. Sometimes it did not & in those instances I would try to call my patient and make them aware of the delay.
On hospice nurse visit day, if I were you I would plan your day to be there for a block of time. Usually the nurse will see a hospice patient weekly thus collaborate with him/her to set a day. Sitting around tapping your foot waiting will only stress you out more. They most likely will be late - it’s the nature of the job. There is a shortage of hospice nurses now. Cut them some slack. Every patient deserves their own time. A nurse just can’t up and leave from a visit to accommodate your schedule. After all, the patient IS home bound so the nurse knows the patient will be there but an effort has to be considered to accommodate the nurses’ schedule as well. Stuff happens. Believe me, that nurse wants her day to go smoothly as well but 9 times out of 10 they WILL be late.
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Reply to Shane1124
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I feel that you should be able to ask whether its a morning or afternoon visit the week before, and which day. Then block that 4-5 hours for her and plan little chores.
In a way as others have said, they cannot plan a 10min visit per client with a 15 min drive between and so plot their day. So a little leeway might help, Also be prepared that her day has turned to custard, and she cant fit in that time slot and have to re organise.
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Reply to muffincat
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I do know your frustrations, I care for my mother also, and because of her weakness she didn't get up @7:00am anymore. She liked to sleep until 9:00am. We liked her to be seen by 10:00am through 1:00pm, only because she was ready for a nap at that time.
Like you said,it worked for about a month.
After that,it could be anytime.

I became more aware of what these Hospice Nurse's go through in one day.
They have too many NTD people to care for, someone could have just passed, they have so much paper work to fill out before pulling out of your home.
Changes of medicines, blood draws, Doctor calls etc.

If it's a half hour all the time,change your thinking.

Because one day you will see they will be staying with you the day your dear love one exits.
Your mother is not their only patient.
Can you imagine their stress?
It's always nice to put on their shoes for one moment.

And this is how I started to look at it and explained it to Mom.

Best Wishes
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Reply to OneWhiteFeather
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First off are you living with her? If you are I would find a half hours notice fine, as long as I knew the day. I do not live with mom and 1/2 hour notice would not be enough for me. Its 20 minutes to get there. Just talk to her. Second, do you like her? If it is a personality conflict do not feel bad. As for a different person. You have to be comfortable with the person. They kind of become part of the family. To me that is not happening. If this is the case just ask for someone different. Explain the traits you are looking for. They will try to match the right person. Hope everything works out.
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Reply to B3z5wb
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I think this is something you need to bring to the attention of the Hospice agency. I doubt if they know she is pulling this cr--. Appointments for home visits, except if there is a set time (although with hospice nurses emergencies will come up) scheduled every week, should be scheduled or at least confirmed the night before the visit. It's a common courtesy offered to all patients receiving any type of home visit (that's my understanding as an APRN who has worked with hospice nurses in long term care facilities anyway), nursing, physical therapy... Unless your mom is REALLY attached to her, I'd request someone who is more considerate. This is a difficult time for you. They should be accommodating you and your mom and not v.v.

Best of luck to you!
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Reply to AginginPLaceLLC
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Nurses have schedules, but there are also emergencies that throw off their schedule.

As an example, late yesterday evening my wife somehow pulled out her catheter, (just the thought of it is extremely painful) I call the nursing agency to schedule a visit within 8 hours of the catheter coming out. The nurse came at 10 a.m. , spent about 45 minutes with us, before continuing his regular schedule.

This can cause a backlog for the rest of his day. Overall I think the majority of nurses try to keep their schedule.
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Reply to garylee
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Due to the nature of the job, when she goes into someone's home for a visit, it might be a planned 20 minute visit that turns into an hour.  And ft that happens to the two appointments in front of you...well you can see where things can get off track.  So I wouldn't expect her to ring the door bell at the exact time that she has an appointment with your mom, however, she needs to tell you the day and an approximate time that she will be there.  If she is going to be off by more than an hour, she needs to call you. 

Having a conversation with her to tell her that you need more of a "schedule" and more communication is not unreasonable.
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Reply to Jamesj
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I am so thankful for my Hospice nurse that I do not care when she comes. I am with my MIL 24/7 so I am home for who ever and when ever they want to come. That being said, you must already have some sort of relationship with her. Speak to her 1st and try to come up with a solution and a better schedule. If that does not work, I am sure there are other nurses they can provide that may be a better fit for you.
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Reply to Aprilealp
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Fire her. These people do not change. You do not have the luxury of letting this nurse train on your moms time.
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Reply to Karsten
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Imho, give her a chance to amend this by speaking with her and tell her that she must keep the schedule previously agreed upon. If she doesn't make the correction, speak to her supervisor.
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Reply to Llamalover47
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Agree! You should have some notice. My mom's home health nurses got on a fairly regular schedule, with the days pretty well locked in, for example, Monday and Thursday every week. They maybe had to vary the times some, but always called in the morning and tried to stay within the range. It was for their convenience as well as mine, so if yours isn't giving you that courtesy, it sounds like she is scattered and a poor planner, as well as not being very considerate. Definitely speak up.
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Reply to tornadojan
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The Hospice Nurse/Company should at least narrow it down to a particular day. They might plan on "about 10 AM" or "about 11 AM," so you have a general expectation. If they are not even giving you any warning of which DAY they might come, no wonder you are irritated!
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Reply to RedVanAnnie
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I have the same issues with my husband’s hospice nurse, but I realize too that she has many patients to visit in a day. I put up with her unplanned visits because hospice is free to us (paid for completely by Medicare). It is an extra layer of safety net that I would not get otherwise. And for $0.

If her unscheduled visits bother you, you should tell her not to come until the scheduled time. You can also not open the door until the appointment time. I agree with others that you should set some sort of limits on your schedule so that you can have some control over your life.
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Reply to Worriedspouse
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I think you need to diplomatically set boundaries with her and see if that helps. If it does not, then talk to the head person in charge to intervene and set some boundaries. I know they are often so busy that they can't cope with so many people so perhaps cut some slack after you set boundaries with her.
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Reply to Lockett2166
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Dear Nurturbynature,
My mother was Director of Nursing for a Catholic Rehabilitation Facility that she worked at for just shy of 20 years. I remember growing up as a teen, she would have talks with us about the rights were for patients in a Nursing, Rehab, or Hospital facility. My mother always said, if we didn't feel like we were getting the care we needed, or that we saw a family member receiving, first stop, the Nursing Supervisor on duty, Second stop Director of Nursing, Third stop facility Administrator, final stop State Dept of Health.
Over the last 20 years I've had many members of my Knights of Columbus Council confined to Nursing Homes, Memory Care etc. One time one of my friends were receiving poor treatment. I went to the Director of Nursing's office, only to find, the DON was a friend of mine whose husband was a member of another council and I'd known her a lot longer than him. I explained what was going on. My friend told me the patient I was talking about who she knew to be a Knight, had Dementia, and couldn't remember many things. She assured me that was so, I still called his son who I knew and told him what his dad had said to me and the conversation with the DON. He told me yes he was aware of the situation and that truly, he was getting excellent care, he just couldn't remember things like when he ate, showered, etc.
There were other times, when I was a patient ie, had an appendectomy, or pneumonia etc. Where, I wasn't receiving Respiratory Therapy on schedule or Meds and complained. Unfortunately our Elderly frequently do not have the ability to advocate for themselves and we need to do it for them. I hope you find this answer helpful to you. I too have Early Onset ALZ and was diagnosed 4 yrs ago at the age of 57. This is a subject I care about and wanted to share what I'd learned from my mother.
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Reply to jfbctc
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It sounds to me like shes calling after shes finished at the house before yours.

i wonder why she doesnt call a couple houses before shes ready for a visit with you.

by the way ... ive found some people can be really rude when responding to something and not helpful at all.
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Reply to Betsysue2002
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disgustedtoo Aug 23, 2020
Yes, some people don't read well and/or assume a lot. They need to learn to ASK questions before spewing trash.

In OP's case, it isn't just calling from the last visit when it is complete, the nurse isn't even setting a DAY for the visit! Just knowing what day, AND understanding that things could change (nurse should be able to give notice ahead if something is going to disrupt that day) so it may need to be rescheduled would be helpful to OP. She could be prepared, even if the nurse ends up later than planned. She's not even given that courtesy!

I wouldn't be happy if someone can't be bothered to at least TRY to schedule something on a day, knowing the time could need adjustment, but instead thinks it is okay to just call as I'm headed over there NOW! Bad enough in general to have anyone drop in unannounced, but when providing care for someone, we need to have time to get things set before the visit!
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Just tell her you need a set time .
if she can accommodate that ask for another nurse . You have the right to have less stress related to your moms care.
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Reply to Arcmiddle14
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During these times with Covid organized and detailed persons such as ourselves need to be flexible. Some agencies are working with reduced staff and often other patients take less or more time than is expected. Please try to be patient, make sure mom is dressed, clean and fed well ahead of expected time. I have had similar issues which always upset my mom who hated people being late. She could not understand the time range of an expected visit. Since she lives in her own apartment on a senior campus I had to drive over early to be ready.
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Isthisrealyreal Aug 23, 2020
That is the whole issue, this nurse isn't giving her an expected time. Not even the courtesy of a day. Just calling with a, "oh is 15 minutes from now good?"

No one should be expected to accept being treated like an afterthought or a time filler.

She is only asking for a scheduled time frame on a specific day.
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Nuture, I am just curious if you have called the hospice provider and told them that you want another nurse and how that has worked out?

Providers have no way of knowing what their nurses are up to if people don't speak up and tell them. This nurse has shown that she is in the wrong industry at this season of her life. Not caring and speaking out of turn are clear signs of burnout.

Our hospice provider for my sister was happy to send other care providers if we were unhappy with them or their attitudes.
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Nurturbynature Aug 23, 2020
@ Isthisrealyreal,

I have not spoken with anyone just yet, and I'm hoping a friendly reset (this week) will resolve this scheduling issue. If it not, then I'll escalate the scheduling issue along with other concerns.

I was just simply seeking suggestions on how to approach this.
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My husband is also on hospice. My hospice nurse comes every Tuesday afternoon; unless she has one of her patient who is passing. When she wasn't available, they would send other nurses and I would have to repeat again and again my husband's issues. Since COVID, I only allow his assigned nurse and his assigned shower guy to come into my home. Remember, they are your employees and you set a time that is convenient for you and they need to work their schedule accordingly.
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Reply to chill47
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I was also thinking of your asking for a different hospice nurse, but any nurse may be a bit early or late depending upon how other visits are going that day.

If you at least know what day the nurse will be coming, make your plans for that day flexible enough to allow for interruption. Don' make other appointments for hat morning or afternoon. Don't start any projects that cannot easily be interrupted.

Don't start making a souffle on Hospice visit day.
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FloridaDD Aug 23, 2020
If they cannot give a better window, OP needs to find another agency.
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Get another person with good reviews.
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Reply to LCPELC
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Start by telling her you appreciate her work. Then, segue into the fact that you expect her to be on time - maybe 10 minutes early but no more than that. Explain that her early visits catch you "unready" for her visit. Thank her for calling before she visits so everybody is ready for her visit. It should work.
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Reply to Taarna
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I never expected visits to always be exactly on time, and they ALL have to call prior to coming over--to make certain you will be there.
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disgustedtoo Aug 23, 2020
I do believe OP is fine with that. If you read all her comments, she isn't being given a day/time range, she's getting a call 30 m before arrival on random days! Not the same as getting a time range and being okay with delays.
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Agencies in elder care know you do not have options, that likely all of them deliver the same substandard service and with the huge demand for elder care it does not matter to them if they lose your business.

Your agency COULD schedule as do repair companies - a particular time block on a particular day. That is not rocket science.
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Reply to mg8751199
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Presumably she has other patients apart from you, and presumably they sometimes need more or less time that is planned. If you get the time you need when she is with you, then stop whining and think that others no doubt appreciate the same.
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whaleyf Aug 23, 2020
Stop whining? That's harsh. She came here to vent and maybe get some help on what to do. You need to lighten up some.
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