If a loved one has palliative or hospice care at a nursing home can family visit during the Coronavirus lockdown?

I know this must be an especially trying time for you and your dad. I’m sorry for that.
If he fits the criteria for hospice care then for sure he should be assessed. Whether this allows you entry is another issue. I would say not but my opinion isn’t the one that counts. Your dad’s doctor might be able to increase his medication or change the way it’s offered without the need of hospice. See if you can get through to the doctor.

Call his palliative/hospice care nurse and tell the nurse that he needs to be evaluated for pain immediately. Even if he is non-verbal, there are objective signs the nurse can assess to determine that he is in pain and how severe the pain is. Is he sweating? Is he grimacing? Is he crying? These are all signs of pain. Your goal is to get him to be resting comfortably.

In california it is only the actively dying who can be visited. I believe you should involve palliative and hospice, yes. And speak to those giving him his pain medications. I doubt that would help you visit but it would certainly help HIM with pain meds.

Have you spoken to the nursing home? In New York State, the ban on visitors does not extend to those visiting someone who is dying.

I would certainly consider professional palliative care for your dad at this time.

In Massachusetts, even if a person is on hospice care, they must be actively dying for the family to visit on their final days. My father is on hospice, but I cannot visit. The only one on the Hospice team that can see him is the hospice nurse.

Call the hospice nurse to discuss scheduled pain medication if that has not already been done. Pain management is most effective when it is given on a regular schedule. Your father should never have to be in pain. Sorry this is happening to him and you.

Our NH is on 30day lockdown. Called hospice and they dais they will still go, unless told otherwise. This is aweful. It weighs on my mind of those who could pass away in there under these circumstances, especially without familt. I heard on local news, some families were going to visit, by staying outside, but visit through their windows.

Are his pain meds given on a PRN basis (per patient request)?

If that is the case and dad is not asking for them, the nurses can't give them. They need to given on a scheduled basis if dad can't or won't request (my mom would tell the nurse she was fine and then call one of us weeping in pain).

Don't bother trying to figure out the "why" of this, just have the pain meds given on a schedule.

We live in Virginia and my mother is also in pain due to broken bones in her hand. Nevertheless, we have been informed that Mom’s hospice care team won’t visit her memory care facility unless she is “actively dying”. Also, her PCP is a visiting physician who has also ceased visiting. Further, we were warned by the PCP if we took mom out of the facility to see a hand specialist, she might not be able to return.
We are now depending on teleconferencing, the facility’s overstretched nursing staff, and our own devices to get through this.
All the best to everyone else in similar straights!

Has dad been evaluated for hospice? He has to be accepted to a hospice program. By all means get him evaluated.

The Hospice that I volunteer for still has CNA's and Nurses visiting patients in their homes as well as facilities.
If dad is on Hospice contact Hospice and see if you can visit.
The building that I volunteer in has their In Patient Unit and they have patients there and they are letting visitors in although it is limited to 3 and they must stay in the patients room. And visitors as well as staff must be screened when entering the building. And the CNA's and others are screened when they enter a facility to care for a patient.
Contact Hospice and see what they can arrange.

In my area, nursing homes and hospitals are allowing visitation for those dying. I would contact the administrator to determine if any visitation is allowed. When speaking with the administrator, discuss your concerns regarding pain management. I would also contact hospice and speak to his nurse regarding your concerns. Maybe a c9nference call with his unit nurse or the DON, the administrator, and the hospice nus3 would be in order.

My father in law has been on hospice/palliative care for a few months. His health is in decline and CA is also on “better at home” till the middle of April. What is considered “actively dying”?

It's up to you. If you put statistics before emotions it would be irresponsible to visit the nursing home, but it is up to you. People can't always put statistics before emotions. Indeed, if they could, we wouldn't shut down the global economy to fight this particular infection.

By all means request a hospice assessment, though - I'm quite surprised he hasn't been offered this before? Meanwhile, call the nursing home, be polite, and bring your father's pain management to their attention. You may have to keep doing that, but if so do keep doing that. Be brief and be courteous. People think they know that the health and care sectors are under pressure, but in fact they haven't a clue. The nursing home may be trying to work out what they can use instead of catheter bags and incontinence pads, while unable to issue their staff with personal protective equipment. That's assuming that they still have all their staff, and haven't had to send many of them home to self-quarantine because they are pregnant, have older relatives, or are parents whose children who aren't at school.

The very worst aspect of the current emergency is the impact the turbulence and disruption are having on people with real, immediate care needs. It's incredibly upsetting and horribly stressful. Grit your teeth, hold on for a week or two, and let people get their contingency systems up and running. It *will* improve.

Does the nursing home have a Friends Of or volunteers' or families' group?

I'm so sorry...I have a friend who is an oral surgeon and I know the cancer's of that sort can be painful and awful. They really should be more attentive to his needs and the pain meds, IMO, should be administered in a way that keeps his pain managed without you needing to be on alert. You can imagine the hassles of following adequate precautions for every loved one who wants to visit, plus the increased risk for them and the patients/residents....HOWEVER, I work in the field somewhat and got an email with official guidelines, which you might be able to google yourself, but I believe there is definitely an exception for family member of those in hospice. And not to tell you what to do...but if you are up to it I would imagine the other choice is to take him out of the facility and bring him home...but then his care would be all on you 24/7. Another issue is probably the shortage of potential supplies for you to put on. I hope it all works out.

Speak on phone to Head Nurse & Doctor there to see if pain meds can be given on regular schedule...this way, they don’t need to check every minute...& sometimes he may not be able to express that he’s in pain, therefore avoiding confusion. You can introduce Hospice, but then facility will more often depend on them to care for him ...I would go for talking to Head Nurses & Dr first.
Hugs 🤗

You are going to have to follow what protocols have been put in place by the particular state's Governor. Speak to the Hospitalist.