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He has a fulminating lesion on the side of his face near his ear. It needs to be removed using the Moher procedure. It is my understanding they won't allow any removal of a skin cancer or other lesion while under their care. Has anyone had an experience with this. That is like saying if you have a cut you can't put a bandage on it. The is very strange.

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You can't get on hospice unless the life expectancy is short (less than 6 months I think). That's why they don't want to continue to treat. Basically, hospice helps you to pass over to the other side as comfortably as possible.
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Hi Pam, thanks for the answer to the question about what happens at the end of 6 months. I never had a clear cut answer. I agree with you about chemo. Personally I don't think that I would ever consent to it for myself or for my loved one. It is a living hell for most people and few actually recover from cancer as a result of chemo treatments. I know there are some success stories, but I don't know of many - actually any by personal knowledge.
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Kiltyone,
As others here have said, not all hospices work the same. The great people we had for our mom were just that; great. They took excellent care of her. While they did take her off "unnecessary" meds, they also sent people to our home to give her physical therapy. They were not in our home everyday but rather 3-4 times a week and of course were on call. The hospice RN was so good to us all. We felt like Judy was a sister. A sister with amazing knowledge and compassion. Hospice also set us up with a volunteer who came once a week for four hours to be with mom so my sister and I could get out for a little "me time". This wonderful person played cards with mom, sat and visited with her or just sat in the room with her while mom slept.
We now have a different hospice group helping with my MIL, they too are absolutely wonderful. They bathe her everyday and make sure she is comfortable. She is in an ALF and between hospice and the staff at the facility she could not be getting better care anywhere.
Talk to some different hospice groups. I think you will find that there are truly angels out there waiting to help you in this very difficult time.
God bless you and yours.
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Sherry hospice provides care at the end of life to provide comfort and ease pain and other distressing symptoms. They do not allow things that may be seen as curative. The patient must have an expectation of dying from their disease within six months but as long as they continue to decline they can remain in the program. If they show improvement and this often happens they leave hospice but can be readmitted at any time. Their personal Dr continues to oversee their care and if they are able they can still visit him/her. Each hospice does have a medical director but thay are not always any easier to contact than a regular Dr. As long as a patient needs something like an urgent new medication the hospice nurses know how to contact the on-call service for that patient's Dr. The hospice nurse is able to directly admit a patient to the hospital if for example she can not keep pain under control with the medications on hand or the caregiver becomes ill.
Hospice care is provided throgh Medicare and many insurance plans or private pay on a sliding scale so if for example you have signed up for hospice and feel strongly you want that tumour removed you can ask to be discharged have the operation using your regular insurance and when you feel the need return to hospice. Things like physical therapy can also be coninued as long as it is in the patients best interests. Going to the ER is strongly discouraged but if for example a patient falls and gets a bad cut they can go to the ER to get sutures either transported by caregivers or ambulance whichever is appropriate.
Part of the problem as with everything else does come down to money. Medicare gives hospice a set amount of money each day to care for each patient and very often just pain meds may exceed that daily allowance. they also have to rent all the necessary equipment and some things like comodes and bath chairs can't be returned so have to be purchased outright. Hospice is prohibited from giving them a good clean and passing on to the next patient.There are so many rules and regulations that a medicare funded hospice has to follow it is a real headache Staff have to be paid and buikldings have to be purchased or rented plus all the incidentals like depends and feed for patients who may have a stomach tube. At the same time illnesses not related to the terminal illness for example someone who is diabetic but terminally ill with cancer can not have their insulin provided by hospice although their nurse can still supervise.
Sherry why not have a repressentative from hospice come out and talk to you and your mother or pay a visit to their office so you can clearly understand what they have to offer. Be aware that some hospices are for profit and others are registered charities. You may find the treatment is more compassionate with a not for profit hospice.Just because your mother is 103 and clearly nearing the end of her life may not yet qualify for hospice care. Ask lots of questions and like everything else if you are not comfortable with the answers don't do it.
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Sherry there are no fines, if the patient somehow improves, they "graduate" from Hospice. We chose Hospice instead of more chemo, because chemo was pure Hell. When you see suffering and no good answers on the Horizon, you call Hospice to END the cruelty.
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I think that in some cases hospice is cruel, especially to the family members. It forbids any intervention which would prevent natural death. Comfort during the dying process is all that is given. Personally, I have a very hard time with it, although my mother at 103 is not doing as well as she was even a month ago, I really understand the reluctance to engage hospice. I'm not sure that I will ever be able to do it. It's psychologically the kiss of death for family members to deal with. I believe that if the patient doesn't die within 6 months of entering hospice that there can be fines. Please correct me if I'm wrong.
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When someone goes on hospice a requirement is no more treatments, no Dr. visits, no calling 911, and no trips to the ER. It's a time of letting go and putting our loved one's care in the hands of someone else who will be there to make sure our loved one has everything they need. Hospice companies have Dr.'s a phone call away (who else can get a Dr. on the phone within 20 min?) and nurses and aides around the clock.

If your husband is not ready for hospice then he has every right to continue doing what you and he think is best. You don't have to have hospice. If your husband still thinks he has some fight in him then support him in that.

Hospice is a Godsend for most families who enlist their help. I know they were for us. No more Dr.'s, no more trips to the hospital, no more procedures.....it was a relief to let go when we realized that my dad had had enough.
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It's not unusual for the spouse to be in denial. kittyone, support your husband's decision, if all he wants is Palliative care, then so be it. Talk to the nurse about how you feel. Counseling and antidepressants may help.
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kiltyone, your profile says your husband's major ailment is cancer, and your topic title says he is going on hospice. This is why responders would assume he is in the final stage of cancer. I am glad for you if that is not true.

Palliative care is not the same as hospice. (My husband was on both, one after the other.) The rules are different. I hope you get your information directly from the agency and don't make assumptions about what he can and can't have treated under their care.

There is no requirement to accept either palliative care or hospice care.
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My husband is in the process of going on palliative care for CHF and minor kidney failure. He does not have cancer other then a facial lesion that can easily be removed and will cause major difficulties down the line. This is very ridiculos. A person should live for possibly many years and have a facial lesion that will cause death? This is really a horrible system. Better to let him stay on his regular system with his own very good insurance. What does hospice do?
Provide a hospital bed and cut off everything else including his doctors. This is not a system I want any part of.
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I am so sorry you are facing this with your spouse. Does his doctor think he should have the procedure? What would be the potential benefit? If you and his doctor feel it is worthwhile having this procedure done, why not delay going on hospice?

But I really agree with Pam. If your spouse is ready for hospice then it is important to face that he is at the end of his difficult journey. If you or he is not quite ready to accept that yet, maybe it is best to postpone going on hospice.

I suggest you have a discussion with the hospice nurse and social worker to learn more about their philosophy and rules.

My heart goes out to you. I remember how very traumatic it was to place my husband on hospice. When you are both ready it can be a wonderful help in facing this stressful time.
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You mean a Mohs procedure, a type of chemosurgery to establish a clean margin? Unfortunately it won't help him. If he is ready for Hospice the cancer is widespread and at this point the prime goal is to make him as comfortable as possible. Further surgery will not save him, it would only add to his pain.
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