My Mom has been on hospice care for over 2 yrs. I thought it was only if you have 6 mos. to live?

Regarding hospice levels of care there are four and they are as follows:

Routine Home Care
This is the most common level of hospice care. Routine home care includes, but is not limited to, nursing and home health aide services. Patients may receive Routine Hospice Care in their home or what they “call home”—in a long-term care, assisted living, or free standing hospice facility.

Continuous Home Care
Continuous Home Care is provided during periods of crisis in which a patient requires continuous nursing care to achieve palliation or management of acute medical symptoms. This intensive care is provided in the patient’s home or facility where they live. In addition to being visited by the team members, the patient will receive up to 24 hours a day care by a licensed nurse and hospice aide, when on Continuous Home Care.

General Inpatient Care
General Inpatient Care is care for pain control and symptom management that cannot effectively be provided in other settings. It is usually of a short-term nature and can be provided in a hospital, hospice unit or long-term care facility. Compassionate Care Hospice has dedicated inpatient hospice units in some of our programs.

Respite Care
Respite Care is short-term inpatient care provided to the patient when necessary for the purpose of providing a break in caregiving to the patient’s caregiver(s). It is only provided on an occasional basis, for a maximum of five days approximately every 90 days. Respite Care is provided in a hospital, hospice unit or long-term care facility.

Please see my prior posts (2) for more information

Are there hospice facilities separate from nursing home facilities or AL? Or is it just a section of those facilities.

Oh I see you answered this "a freestanding hospice facility". missed that first time and it doesn't let me delete my dumb question., sorry.

My husband went to a hospice facility which was all they did was hospice We were fortunate to get him as he got 24 hour care. This wouldn't have been the case if he stayed home.

LCSW- What tough questions should we be asking?
My mom is in a nursing home, terminal Alzhheimers, slow decline, I have no idea what I should be asking.

My 93 yr old mother was on hospice 2 years ago and although the nurses visited and the sent an aid to help her bath the majority of her care was still on me. They put her on pain killers that made her have falling problems, even with her walker. She still wanted to walk to the bathroom during the night, even if the bed rails were up and she had a diaper on. She would try to climb over the railings and call me for help. Then they had me give her anti anxiety medicine that made her even more unstable. After 6 weeks of her crazy behavior and 5 different hospice nurses visiting, I had to call 911 for help at 3am because she was violent and uncontrollable. She had a UTI that all 5 nurses missed. How do those of you that think hospice was so helpful think that? I felt like they made things harder for me. They medicated for pain, but that made her walking very difficult but my head strong mother still wanted to walk. If I settled her in bed at night with the railings up she called and woke me up 4 or 5 times. Hospice was no help to me. Now the dr wants to again put her on hopsice care and I'm afraid it will be the same. They mostly care about pain meds and pain meds make my mother unstable, but they want to fix her pain. No amount of pain meds fix my mother's pain, strong pain meds that hospice has given her just make her sleep and when she's awake she's very unsteady. So they go home and I'm left with someone who needs constant supervision. How is that helpful?

Can 72 year old total alcoholic be put on hospice?

Hi Lovingmom. I will get back to your question, I'm just a little tight for time at the moment. Probably I will post tomorrow or the next day. Take care.

Christine--
You need to provide more information. A 72 yo alcoholic who can....still care for themselves? Lives alone? Has no real health problems besides the alcoholism? You can't just snatch somebody and place them in Hospice care, they have to pass some pre-testing. Being an alcoholic, placed into Hospice? if they are still actively drinking? Probably not, because Hospice is pain meds and end of life care--that isn't going to work with a load of booze on board.

Smikulick--I am sorry for what you are going through. Yes, having a loved one in Hospice care at home does make for a lot of work for the caregiver. I am sorry yet grateful that when we placed daddy in hospice, he no longer could get out of bed or walk at all. I can't imagine if he had tried to do so, he was a big man and I personally would have had to call paramedics to help me.

As far as the hospice nurses not catching the UTI--well, I don't know. Ours did a stellar job with daddy, testing his blood and urine each time they came. UTI's are common in patients with catheters. Also, the blood tests would reveal any infections, etc. Maybe Hospice isn't the best course for you if mother is still ambulatory? Or maybe you need to move her to more intensive care. These problems you mention aren't the fault of anyone..it's the situation, which is very sad. Your mom wants to walk. She's in pain and not aware of her surroundings. This can go on for a long time. Maybe you need to re-evaluate having mom with you? Just a thought. Sounds like more care is needed than you can give.

Hi Lovingmom,
So sorry to hear about your mother. Alzheimer’s is such a challenge, it’s good you are thinking of planning ahead. It is quite likely that she will eventually be just bed bound and sleeping more and more until one day she doesn’t awake. In which case you may need nothing more.
Important question number one. Did your mom, while of sound mind, create Advanced Directives giving guidance as to what she would prefer? If not, did she ever talk about whether or not she would want heroic measures *even* if she were terminal? If she did not, you are faced with the task of deciding what she may have wanted and what you feel is appropriate. Tough question number two: how do you want life to end?

The decision point here would come if her Alzheimer’s takes the course where she eventually stops eating, or eats so little she is wasting, or can no longer drink water. At that point the body has run its course and is beginning to enter the dying phase. Many people, facilities, and religions are uncomfortable with this and want to institute tube feeding and forced hydration at this point, regardless of the state of the patient’s consciousness. The tough question here is quality of life. Would she want to have lived like this? If not, it is time for a hospice consult.
What hospice will do is give her medications to keep her comfortable and allow the body to take its course. Usually death is no more than a few days to a few weeks off (if the assessment is correct). At the very end some will argue that it is cruel to “withhold” water, however, to inject fluids when the body is no longer capable of pumping them out is essentially forcing the person to drown. An MD or experienced hospice RN should assess to see if this is indeed where the patient is at.
I hope this gives you some starting points. Peace to you and your mom.

Can I start hospice care at home

Yes, it is called home hospice. My late husband was under home hospice care for more than a year before he was admitted to a nursing home, where he continued to be under hospice care until the end of his life. At home he received medical care from a hospice nurse and bathing care from a hospice aide. A hospice doctor visited monthly to determine whether my husband was still eligible for hospice care. I highly recommend hospice care for the benefit of the patient and family members.

My aunt was in hospice care at home for ten years with dementia.