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We transferred my Mom to a local Hospice today and we aren't very happy. They aren't used to people that want to use a bedside commode or occassionally try to get out of bed or use a walker. Mind we aren't sure she can even use it (the walker at this stage) but she has Dementia (duh) and wants to try. They dont have their own kitchen ..they order from a local restaurant and the nurse patient ratio the tour volunteer guide gave my sister isn't accurate. She was brought in at 4 pm and no meds yet (except Morphine) and hasn't seen the social worker. We were told she'd be right over, 3 hours ago. As you can imagine we aren't happy. I'm thinking of doing home hospice and just hiring staff at least for night shift.


Is this normal? Ive only worked with Hospice staff thru the nursing homes.

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We are going to give it a few days to see. It is a very small facility and she seems to be doing ok. ( so far) . She was at home until a recent rash of hospital visits. Her co2 is the problem and she wont do a mask . So we are basically out of options . She cant always bare her own weight or pivot so, unfortunately i cant really help her just myself at home anymore. There just are no good solutions at this point .. you can only make the best decisions you can
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Reply to baskethill1
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It sounds like your expectations are for the standards of a full service facility to come from a very small group home type of place, and also expecting that staff is to be 24/7 at the ready to attend to your mom.

The math doesn't work for these to ever happen in small place unless it’s higher end private pay that has the budget for a DON, add’l RN or NPs, full or part time LCSW and Activities Director, several CNAs, general housekeeping staff, etc. Rough guesstimate would be $4500 from MediCARE & $25k private pay each mo needed to cover salaries for a smaller hospice care home of 8/10 beds / 4-5 double rooms without on site full dietary. Otherwise it’s going to be bare bones on staffing and to make that work the residents need to be bedfast with a set pattern to depends changes, gerichair bathing, meals, medications, etc. Residents can’t be getting up whenever and moving about, it’s needs to be “butts in bed” to manage the limited budget.

If your mom was in a NH before and you weren’t pleased, and moved her and now not pleased, to me your never going to find a facility that meets your expectations unless it’s a very high end costly facility that caters to residents & families whims.

If you move her out & do in-home hospice, you need to make sure that there is someone always always on call & fully “in attendance” 24/7. Hospice will provide staff for a few hours perhaps 3-4 days a week or if their in final death stages perhaps daily. But family or hired caregivers need to be there all the other time. Hospice can train you on how to administer medications; some cities have programs for families on medication management and if yours does please try to take it especially if your mom is on opioids or black box warning drugs. Once it’s in-home hospice there’s NO running to grocery store, garden center, school, etc. leaving her unattended. I’d suggest you look into a video system to be able to monitor her continuously from wherever you are in the house or out in the yard.

my Mom was on hospice in a NH 18 l...o...n...g months. The NH and the hospice group worked in tandem for her care and it was beyond wonderful. There were glitches at the first and I switched hospice providers within first few weeks, which your mom or you as her dpoa / mpoa can do as it’s a MediCARE Benefit so it’s self directed & she/you can pick the vendor. The glitches were centered on communication; 2nd hospice group would Skype me from mom’s bedside and emailed me bi monthly status reports, attend the NH care plan meetings....... things first group would not do.
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Reply to igloo572
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Be aware though, Hospice is a 24/7 thing. Someone needs to be with Mom all the time, Nurses only checkup every 3/4 days, Aides are there for just a short period.

The answer to your question are they have to be bedridden, is no. I would be concerned about this place to. No Kitchen! I can see the food being brought in but I can't understand no kitchen at all.

If Mom's time is short and you r willing to do the care, like I said aides are not there 24/7, then do it.
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Reply to JoAnn29
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The only stand alone hospice facilities I know of are very small - less than a dozen patients. I imagine 90% of the people in a hospice facility are days or weeks at most away from death so they aren't likely to be up and active.
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Reply to cwillie
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When someone is in a hospice facility they are just one among many and some facilities are better than others. But yes, most people in a hospice facility are bedridden.

If you opt for hospice at home the hospice company will provide you with everything that's needed to care for your mom from a hospital bed to Depends. They supply medication, barrier cream, and a bath aide among other services. Many people with in-home hospice also hire caregivers to tend to the person, a supplement to the services that are already offered. Many hospices provide spiritual support, social support, counseling to the family, and regular nursing visits.
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Reply to Eyerishlass
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