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V. Complaints. Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights. APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.I agree that: A.I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information"). B.APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink. C.APFM may send all communications to me electronically via e-mail or by access to an APFM web site. D.If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records. E.This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year. F.You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
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Hang in there, Beverly. It's hard. My mother was just put on hospice a few weeks ago. She's been in memory care for a little over 2 years with Alzheimer's, congestive heart failure, and Parkinson's. After her 4th fall in a month the facility suggested that "it's time." Honestly, I'm thrilled about her having the opportunity for hospice. It means more eyes and hands on her (RN visits 2+ times per week), chaplain visits, access for me to a social worker when my mother passes, and so on. She can eat and drink just fine "today," but we all know how quickly that can change. I'm glad she/we are able to establish a relationship now with the hospice team prior to the time when she stops eating, loses consciousness, and starts her journey to the other side.
Hospice will give you no respite from mother since you still have to care for her 24/7 while she's under hospice care at home. What I don't understand is why you haven't used MOTHER'S funds to HIRE in home help to relieve you of this burden and anger you feel??? She makes too much for Medicaid, you say, so why not use some of that money to get out of the house for the day and relax, calm down? Your mother is not the only one who needs "the right thing" done for her......you are another player in this game! Get hospice, yes, but that's a few hours a week, if that, where a nurse stops by to take vitals, and a CNA comes by to bathe mom. A chaplain and social worker stop by periodically, and that's it. You dole out the meds and do all the rest of the care, same as always.
My mother had vascular dementia and lived in Memory Care Assisted Living. She had hospice come on board in Dec of 2022 and she didn't seem close to death either. Yet she was in her 6th yr of this aggressive form of dementia. On Feb 15, she felt tired after breakfast and went to bed. She became semi comatose and never woke up. She died exactly 7 days later, peacefully, and in no pain.
We have no idea when an elder will pass, in reality.
Allow hospice to explain their goal to you. To keep mother comfortable, w/o taking life saving measures to keep her alive. To keep her out of hospitals and away from poking and prodding and imaging. The goal of hospice is to allow nature to take its course w/o needless interventions. You dole out comfort meds as needed. Addiction is not of concern because the patient is now at end of life. The goal is to stay comfortable and free from anxiety only. Hospice can be fired at any time. Please read their paperwork and understand that their goal is not to kill your mother but to keep her comfortable. So many folks come to A.C. after a parent dies accusing hospice of "killing" them when it was the disease or condition that was the cause, not hospice. It's important to know what you're signing up for when you do.
I had good experiences with hospice for both of my parents. Although its a very unpleasant experience to watch a loved one die. In my opinion, it's worse to see that loved one continue to suffer with dementia day in and day out than it is to be at final and perfect peace with God.
My late husband had vascular dementia and was under hospice care in our home the last 22 months of his life. I'm sure you're aware that vascular dementia is the most aggressive of all of the dementias with a life expectancy of just 5 years, so if your moms had it for several years now it may be time to bring hospice on board. And keep in mind that just because hospice is brought on board it doesn't mean that your mom will die anytime soon, because like I said, my late husband was under their care for the last 22 months of his life. Bringing hospice on board will mean extra sets of eyes on your mom, with a nurse coming to check on her once a week to start and aides coming to bathe her about twice a week. They will also supply any and all needed equipment, supplies and medications all covered 100% under your moms Medicare. I wish you well as you make the decision to do what is now best for your mom.
Thanks for all your help. She is declining but I don’t see her near death soon. I will just be thankful to have help. It’s so hard since I am the only child left living. Thank god for my husband who is a lifesaver for me. It’s just so physically and mentally exhausting. But hopefully with hospice we can get a little relief.
My mom has what we call "valleys" and "rallies." This year, there have been about six days when she has seemed near death: sleeping to the point of being unresponsive for many hours. The next day, she's back at her "new normal": conscious, able to go into the dining room for meals, talking, etc. She regularly has hallucinations, so I wouldn't necessarily classify this behavior as caused by impending death. A few weeks ago, a hospice nurse said Mom might live for three more years like this.
That must be extraordinarily difficult. Prayers for you and her.
My dads decline was mostly valleys followed by a cliff followed by his active dying under hospice. It took 11 days. I suppose we were the fortunate ones.
My friend's husband with the same issues as your mom passed away in hospice care a few weeks ago. He was in memory care, and the hospice organization is owned by the same family company as the memory care. "Roger" had mixed dementia and was incontinent. He also had palsy, couldn't walk or speak except for a few words now and then. He did understand what others were saying to some extent. He had a beautiful smile and reacted to events around him.
However, he began to spit out his food though he'd been a good eater. Then he started being unable to swallow every time. He'd cough food and saliva up. Eventually, for days, he refused to eat and fell asleep instead. He began to sleep all the time except for brief waking periods. His body was shutting down. Hospice doctor and nurse conferred with his wife, and they all agreed that Roger would no longer be offered food. In such a case, the patient feels pain if they drink or eat. Wife and family gathered at the facility to say goodbyes and were there for several hours. I was there to lend support. Roger was slightly aware and smiled.
When they left at 5 p.m., morphine was started and he went to sleep in his room in his bed. Hospice nurses stayed with him constantly. Roger was turned on a regular schedule. His briefs were changed on schedule also. This continued through the next day, and he slept peacefully. Family was in and out, telling him they loved him and holding his hand, smoothing his hair, and talking quietly with each other. In the early hours of the following day, Roger passed gently after a few deep breaths and then no more. His family was grateful for his peaceful passing. His son, an R.N. who had worked with hospice in the past, said that medical protocol was followed perfectly and that they couldn't have asked for better care for his dad.
I’m just so confused with this vascular dementia. Today she was able to eat a grilled cheese sandwich really well. And another minute she can’t swallow at all. I’m sure she is in the last stages because she seems to be talking to people who aren’t there. I think now is a good time for hospice. They are coming Friday to discuss everything.
unjust want to be doing what’s right for her. Thank you all for all your help.
My mom, age 97, lives in an assisted-living memory care facility. She has been receiving hospice services for more than 1 year. The hospice services were approved because of a tentative diagnosis of congestive heart failure; mom also has cognitive issues that might be caused by vascular dementia. My family has been very satisfied with the hospice services.
My dad’s official diagnosis was frontotemporal dementia (FTD), but his neurologist said his brain deterioration was consistent with Alzheimer’s, FTD, and vascular combined.
He got to the point where he was falling almost every time he tried to stand and he had swallowing problems and incontinence and other issues.
We elected hospice and I think it was 100% helpful and the right decision for him. I would do it again, no question. I think you are doing the right thing. That doesn’t make it easy. It’s hard. It’s sad. But hospice is there to help you both through it.
The hospice provider we used had 24/7 phone support where a real human answered day or night. The nurse or nurse coordinator would call you back with any questions. The nurse would come once a week or for emergencies. They also had an in-patient facility where in the end we did take my dad as it was no longer safe or practical to manage him at home his last few days. We could visit him there 24/7 but trained professionals did all his care and they were kind and compassionate.
Hey bev. My dad was on hospice. Here are some takeaways both good and bad.
Hospice is a doctor managed process in name only. The point of contact is usually an RN and not a RN that has managed to get the NP or PA credentials either. We had a member here very recently stating that an rn had ORDERED THEIR FAMILY that there was to be no more food or water despite the client still wanting it and being able to consume it. I would choose a hospice that will have a 24/7 number to that docs answering service.
I would also consider going with a hospice with a dedicated hospice home.
Having read your answer below to Barb, Beverly, I think I understand. Your mother, it would seem as severe end stage dementia now, is likely more or less bed bound and you indicated is incontinent and cannot swallow. Indeed this is the progression with end stage dementia and it looks like the doctor is suggesting that she is extremely unlikely to survive anywhere near another 6 months. This definitely happens when there's no ability to swallow. Left in this condition eventually Mom would stop reacting at all, curl into a fetal position where she would get bed sores and contractures.
Attempts to feed at this point create really only a good chance of aspiration of food into the lung, and aspiration which would cause pneumonia and death. Once, long ago, pneumonia was known as "the old person's friend" in that it ushered them out of this veil of suffering.
I would discuss with Hospice now what is happening, what is provided, what to expect. Do consider tuning in on youtube to free videos by Nurse Julie, who is in fact a hospice nurse.
Many of us here have seen our loved ones out via Hospice when there was no hope. My own brother died in Hospice care when he got sepsis from a small sore on his shin, and was completely resistant to any antibiotics we currently have. He died within weeks.
While Hospice may, with the administration of drugs to prevent agitation and confusion and hallucination as toxins build in the body and the organs shut down, cause death to come a bit more quickly than it would by some minutes, hours, days, even weeks, the goal now is comfort and mercy.
I am sorry for your loss. If you have specific questions go to your hospice team. If you wish to ask them here, do come back to us. Holding you in thought. This is very difficult, we know.
Does your mom have any other health issues aside from Vascular Dementia?
My mom was admitted to a NH with Vascular Dementia, CHF and broken hip in 2013. We were told that she was hospice eligible.
I wanted to sign on to that, but my brother, who was co POA with me said no. Mom lived for another 4 1/2 years, got a pacemaker, survived two bouts of pneumonia and a couple of chest taps for fluid buildup.
This was NOT what I would have chosen for myself; mom made us CO health POAs so we needed to discuss and agree.
No she doesn’t have any other health issues. She is just at the point where she can’t walk on her own, has trouble swallowing and has to wear diapers. She keeps falling when she tries to walk. I just want to make sure it’s the right thing. I am her only caregiver.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
My mother had vascular dementia and lived in Memory Care Assisted Living. She had hospice come on board in Dec of 2022 and she didn't seem close to death either. Yet she was in her 6th yr of this aggressive form of dementia. On Feb 15, she felt tired after breakfast and went to bed. She became semi comatose and never woke up. She died exactly 7 days later, peacefully, and in no pain.
We have no idea when an elder will pass, in reality.
Allow hospice to explain their goal to you. To keep mother comfortable, w/o taking life saving measures to keep her alive. To keep her out of hospitals and away from poking and prodding and imaging. The goal of hospice is to allow nature to take its course w/o needless interventions. You dole out comfort meds as needed. Addiction is not of concern because the patient is now at end of life. The goal is to stay comfortable and free from anxiety only. Hospice can be fired at any time. Please read their paperwork and understand that their goal is not to kill your mother but to keep her comfortable. So many folks come to A.C. after a parent dies accusing hospice of "killing" them when it was the disease or condition that was the cause, not hospice. It's important to know what you're signing up for when you do.
I had good experiences with hospice for both of my parents. Although its a very unpleasant experience to watch a loved one die. In my opinion, it's worse to see that loved one continue to suffer with dementia day in and day out than it is to be at final and perfect peace with God.
Best of luck to you.
I'm sure you're aware that vascular dementia is the most aggressive of all of the dementias with a life expectancy of just 5 years, so if your moms had it for several years now it may be time to bring hospice on board.
And keep in mind that just because hospice is brought on board it doesn't mean that your mom will die anytime soon, because like I said, my late husband was under their care for the last 22 months of his life.
Bringing hospice on board will mean extra sets of eyes on your mom, with a nurse coming to check on her once a week to start and aides coming to bathe her about twice a week. They will also supply any and all needed equipment, supplies and medications all covered 100% under your moms Medicare.
I wish you well as you make the decision to do what is now best for your mom.
My dads decline was mostly valleys followed by a cliff followed by his active dying under hospice. It took 11 days. I suppose we were the fortunate ones.
However, he began to spit out his food though he'd been a good eater. Then he started being unable to swallow every time. He'd cough food and saliva up. Eventually, for days, he refused to eat and fell asleep instead. He began to sleep all the time except for brief waking periods. His body was shutting down. Hospice doctor and nurse conferred with his wife, and they all agreed that Roger would no longer be offered food. In such a case, the patient feels pain if they drink or eat. Wife and family gathered at the facility to say goodbyes and were there for several hours. I was there to lend support. Roger was slightly aware and smiled.
When they left at 5 p.m., morphine was started and he went to sleep in his room in his bed. Hospice nurses stayed with him constantly. Roger was turned on a regular schedule. His briefs were changed on schedule also. This continued through the next day, and he slept peacefully. Family was in and out, telling him they loved him and holding his hand, smoothing his hair, and talking quietly with each other. In the early hours of the following day, Roger passed gently after a few deep breaths and then no more. His family was grateful for his peaceful passing. His son, an R.N. who had worked with hospice in the past, said that medical protocol was followed perfectly and that they couldn't have asked for better care for his dad.
unjust want to be doing what’s right for her. Thank you all for all your help.
My dad’s official diagnosis was frontotemporal dementia (FTD), but his neurologist said his brain deterioration was consistent with Alzheimer’s, FTD, and vascular combined.
He got to the point where he was falling almost every time he tried to stand and he had swallowing problems and incontinence and other issues.
We elected hospice and I think it was 100% helpful and the right decision for him. I would do it again, no question. I think you are doing the right thing. That doesn’t make it easy. It’s hard. It’s sad. But hospice is there to help you both through it.
The hospice provider we used had 24/7 phone support where a real human answered day or night. The nurse or nurse coordinator would call you back with any questions. The nurse would come once a week or for emergencies. They also had an in-patient facility where in the end we did take my dad as it was no longer safe or practical to manage him at home his last few days. We could visit him there 24/7 but trained professionals did all his care and they were kind and compassionate.
Best wishes to you getting through this.
Hospice is a doctor managed process in name only. The point of contact is usually an RN and not a RN that has managed to get the NP or PA credentials either. We had a member here very recently stating that an rn had ORDERED THEIR FAMILY that there was to be no more food or water despite the client still wanting it and being able to consume it. I would choose a hospice that will have a 24/7 number to that docs answering service.
I would also consider going with a hospice with a dedicated hospice home.
Indeed this is the progression with end stage dementia and it looks like the doctor is suggesting that she is extremely unlikely to survive anywhere near another 6 months. This definitely happens when there's no ability to swallow. Left in this condition eventually Mom would stop reacting at all, curl into a fetal position where she would get bed sores and contractures.
Attempts to feed at this point create really only a good chance of aspiration of food into the lung, and aspiration which would cause pneumonia and death. Once, long ago, pneumonia was known as "the old person's friend" in that it ushered them out of this veil of suffering.
I would discuss with Hospice now what is happening, what is provided, what to expect. Do consider tuning in on youtube to free videos by Nurse Julie, who is in fact a hospice nurse.
Many of us here have seen our loved ones out via Hospice when there was no hope. My own brother died in Hospice care when he got sepsis from a small sore on his shin, and was completely resistant to any antibiotics we currently have. He died within weeks.
While Hospice may, with the administration of drugs to prevent agitation and confusion and hallucination as toxins build in the body and the organs shut down, cause death to come a bit more quickly than it would by some minutes, hours, days, even weeks, the goal now is comfort and mercy.
I am sorry for your loss. If you have specific questions go to your hospice team. If you wish to ask them here, do come back to us. Holding you in thought. This is very difficult, we know.
Does your mom have any other health issues aside from Vascular Dementia?
My mom was admitted to a NH with Vascular Dementia, CHF and broken hip in 2013. We were told that she was hospice eligible.
I wanted to sign on to that, but my brother, who was co POA with me said no. Mom lived for another 4 1/2 years, got a pacemaker, survived two bouts of pneumonia and a couple of chest taps for fluid buildup.
This was NOT what I would have chosen for myself; mom made us CO health POAs so we needed to discuss and agree.