There is one agency recommended by the Palliative care coordinator but they are refusing. This is a Medicare appointed program! How do I go about getting help?
There really is no agency needed in "palliative care". Palliative care is a treatment option. It is often run by a palliative care physician, but it need not be. It is a simple decision for patient or patient with or through his POA refusing treatment for future care. It is to say that you do not wish to TREAT any medical occurance but that you wish to be made COMFORTABLE. It is for end of life (elderly) or end of illness (hopeless more or less, or treatment options so odious you choose not to "go there"). Palliative care is a choice through your own mouth or through those with POA for your health care. It means "I know that I am close to the end of my life whether because of age, or illnesses, and I choose to FORGO further treatment, and I direct the MD in my care to carry forth my wishes to make me comfortable. USUALLY hospice is brought in at this point. Speak with the MD now of the patient concerned to see how to proceed, what papers you need implemented if any, and how best to legally express your wishes or the wishes of the person you have the power of attorney for. See an Elder Law attorney if at all possible to see how to implement these wishes. Certain things will be done such as, in the USA, a POLST which is physician orders to be followed if patient collapses in home and EMT is called in. The First Responders are by law to attempt to resuscitate without this posted order in the home for them to follow. Good luck.
Is this an in your home for hospice / palliative situation & is happening because it’s a level of care issue? Like the person is very large, needs a hoist, etc and the hospice provider cannot do care needed as neither their employees or the volunteers can physically deal with the individual or that they need black box warning drugs (like Fentanyl) and the hospice provider won’t take that type of care needed as it’s too risky (they are targets in iffy neighborhoods for robbery to car break in), or the hospice group is small so that there’s only 1 or 2 RNs that are bonded to do opioids.
if either of these might be the reason, then you probably need to look at getting placement with a big hospice company like VITAS or get them into an in-unit hospice situation or move them into a NH so that they have NH staff plus the 2-4 day a week hospice staff coming in for care.
My MIL was on in-unit hospice..... she was in NH, got ill then hospitalized, became septic & infectious, was starting into cascading organ shut down.... so was discharged from hospital to an in-unit hospice only facility that was adjacent to the hospital. If they are really close to death, they can do this and MediCARE will pay for a period of time if their chart shows they need hospice or palliative care in a specialized facility. Her being infectious was the reason used & she dyed within her first month & all covered by Medicare. What was interesting was that this in-unit was mainly younger patients at end stage cancer & needed serious opioids or other drugs with lots of oversight and was beyond what family could deal with safely at home.
Is your LO in a facility or at home? Have you checked with Doctors visiting homes or those that visit facilities? I know that when I explained to the doctor who visited my LO in her MC, he said, oh, okay. If you want Palliative we shall proceed with that. So, he discontinued some meds and started actually treating her for keeping her comfortable. Later, we went to Hospice care. If my LO comes off Hospice, we shall continue with Palliative care. Also, as Igloo says, some Hospices have a Palliative Care division.
Like the person is very large, needs a hoist, etc and the hospice provider cannot do care needed as neither their employees or the volunteers can physically deal with the individual
or
that they need black box warning drugs (like Fentanyl) and the hospice provider won’t take that type of care needed as it’s too risky (they are targets in iffy neighborhoods for robbery to car break in), or the hospice group is small so that there’s only 1 or 2 RNs that are bonded to do opioids.
if either of these might be the reason, then you probably need to look at getting placement with a big hospice company like VITAS or get them into an in-unit hospice situation or move them into a NH so that they have NH staff plus the 2-4 day a week hospice staff coming in for care.
My MIL was on in-unit hospice..... she was in NH, got ill then hospitalized, became septic & infectious, was starting into cascading organ shut down.... so was discharged from hospital to an in-unit hospice only facility that was adjacent to the hospital. If they are really close to death, they can do this and MediCARE will pay for a period of time if their chart shows they need hospice or palliative care in a specialized facility. Her being infectious was the reason used & she dyed within her first month & all covered by Medicare. What was interesting was that this in-unit was mainly younger patients at end stage cancer & needed serious opioids or other drugs with lots of oversight and was beyond what family could deal with safely at home.