I called his palliative care nurse as he was having issues with long bathroom sessions - short term memory loss and weakness - me not getting sleep at night .Said to cancel orthopedic appt and foot appt- said wound care nurse can come and care for toe ulcers. He is still mobile with his walker - does his own toileting and depend changes. He has an aide for sponge baths - eats well etc.
Question is hospice says you can no longer call 911 in emergency or in case you fall. You need to call us. If we need 911 we will call when we get there. The intake nurse said he should no longer wear his medical alert which is just a basic fast help button to 911 and is not connected to any subscription monthly bill or contract. Just a one time purchase for it. It’s called fasthelp.com website. Said we need to notify transponders to stop the device which it is not. She didn’t quite understand. I could even wear it out. No one person is connected to it. Even with his MOLST on refrigerator paramedics will transport you to hospital if they deem necessary ie stiches needed bleeding if on thinners etc. My Dad does not want to be without it. We also have lockbox for them to get in. I still need to go to my appts and grocery store bank etc. So since she wasn’t sure we and she decided to let my Dad keep wearing it for now.
I spoke to a friend who was caregiver to her husband. She said you should do what you want. They tell you not to call 911 because they are the ones who want to make money from Medicare
Opinions please?
I
If they think that it is an event that he should go to the hospital for they will make that determination.
I have to tell you that if you call 911 and they try CPR on him most likely ribs will be broken. Possibly his sternum will be broken. I have to wonder at 100 would he recover from that?
If you do not think he should be on Hospice you can revoke it and return to Palliative Care and his own doctors.
If he presses his "help button" I am sure that they will contact 911. So if you decide to have him remain on Hospice discontinuing the service is what you would do.
If someone is not there with him all the time and he does have an emergency where he would call 911/use the help button and you can't get him to call you or Hospice instead this might not work. Someone should be with him at all times if this might occur.
It is not that Hospice wants to make the money from Medicare it is a duplication of billing/service if he is on Hospice and is admitted to the hospital. So what happens if Hospice decides that the event warrants a hospital trip they will discharge him from Hospice for the time he is in the hospital. Once released he can go back on Hospice. If he is not discharged from Hospice I would imagine the hospital visit, ambulance ride, paramedic charges would be an "out of pocket expense"
Maybe remaining on Palliative is what you want for your dad
Maybe Pallitive care is what your looking for.
"Palliative care offers symptom relief and support for serious illnesses at any stage, alongside curative treatments, while hospice is a specific type of palliative care for the final months of life (typically <6 months prognosis) with no further curative focus, centering entirely on comfort, dignity, and end-of-life support for both patient and family, and is often Medicare-covered. The main difference is timing and goal: palliative is broader and concurrent with treatment; hospice is terminal and replaces curative care."
When my 105-yr old Aunt had a stroke right in front of me, she was not yet on hospice so I had to call 911 but went to the hospital with all the legal paperwork and had to literally yell at the staff to stop sticking her with needles and doing things to keep her alive. At that point she was paralyzed on her right side and couldn't even swallow water or food.
You will need to decide which is it for your Dad: hospice or continued life-saving efforts when it comes to making the decision -- so that they don't work against each other and rob your Dad of as peaceful and pain-free of an exit as possible.
I'd also like to remind you that if something catastrophic happened and you just felt that it had to be addressed for his comfort, you can always withdraw your dad from hospice, but I would cross that bridge when you come to it.
Why not use a ring camera to check on your dad while you are gone? If he falls, you can call him or rush home? I do think if you let 911 get called automatically you might find your dad in the ER full of needles by the time you get there, and you'll have a lot of trouble unwinding whatever is started for testing and evaluation which you are trying to avoid now.
If I have appt in the am he sleeps till noon soI am back by then.
I know of one person with late-stage dementia on hospice who wanted "no intervention" but when a young person was alone with her and she started having issues, the person panicked and called 911 which led to an ambulance ride with sirens and a distressing and bewildering hospital stay, when the plan had been to keep her out of the hospital and just comfortable. In another instance a family member panicked and caused injuries doing CPR, leading to a hospitalization, instead of letting the senior just go naturally.
I know there are others here with better information about the whole process.