I am her Health Care Surrogate but as they won't declare her incompetent it has not come into effect. I believe the home's intent is to prevent me from making the decision regarding hospice and instead to pressure her to enter it in various ways. This allows them to say "we are doing the right thing and following the patient's wishes" and to cast me as a family member who simply refuses to let go. They are asking her almost daily, as far as I can tell, if she wants to enter hospice. I live out of state and am not present (neither is any other family member). She is very weak and has bad days where she expresses a desire to die, she has come to view hospice as a "way out".
I am not anti-hospice and expect her to enter it in the near future, but want that to be my decision, not the home's (even if it's portrayed as hers). One concern I have is that once the hospice team takes control of her care, they will be who decides if she goes to the hospital when she has a problem. Obviously, they are incentivized against it and I do not want to be arguing with them about whether or not she goes in.
I do not know if the home has a financial arrangement with the hospice care company; I believe they simply think it will be easier on them if she is in hospice as they won't be caring for her as much and won't have to be sending her to the hospital as often.
Apart from applying for guardianship, which could be complicated and expensive, does anyone have any other suggestions on how to deal with this situation?
Why does it have to be on YOUR terms when she enters hospice? If MIL is mentally sound, it’s her choice.
Wouldn't you rather that she just be kept comfortable and pain free so she can die in peace?
It sounds like your MIL has already made her decision as she's ready to die, so I'm not clear as to what your hesitation is, unless you are not to the place where you're ready to let her go yet. And if that's the case, that is your issue not your MIL's. Please don't let her suffer needlessly.
Perhaps you need to do some more research about hospice to find out exactly what to expect. They are not the enemy, but are there to help the transition from this world to the next as smooth as possible.
I agree that you should do some research and choose the hospice you
prefer—this might be a way to feel less manipulated and more a part of the best possible outcome since you anticipate her entering hospice in the near future.
Hospice is end of life. The facility gains nothing in having them come in. Medicare pays for the service not the room and board. She will be kept comfortable. Morphine for pain and trouble breathing. Anxiety meds to keep her calm. A doctor does not usually recommend hospice unless its needed. It also means, no more hospital visits.
My Mom was in LTC. She was 89 with Dementia. I was told the doctor recommended her getting evaluated for her swallowing problem. This is first sign of the body shutting down. She had already refused to get out of bed and closed her eyes not opening them again. I was not going to allow them to poke and prod her. I said time for Hospice. My RN daughter came and examined her and said it was time. I went to visit her with my disabled nephew who had lived with her and left at 1:30pm, she passed peacefully at 1:50 pm. I have never regretted my decision.
Hospice provides another set of eyes on MIL and a level of care that she needs now. Don't prevent this help for MIL out of some misinformed ideas that you have. At the very least, you could call the hospice team and discuss your concerns.
Your mother has expressed a wish to go now. Please honor that and get her into hospice. This isn't your decision or theirs. This is your mother's decision.
A doctor has to recommend it for her.
Hospice has also provided a special hospital bed, a padded wheelchair, a shower chair, a raised potty seat, all at no charge to us, and even provides the adult briefs, sanitary gloves and wipes, and pays for any medication consistent with Mom's diagnosis. They have also met with me and the facility staff and been a part of the care plan for my mother going forward. Medicare pays for these services and the way it was explained to me, it is something that we are eligible for after working so many years and paying into FICA taxes that fund Medicare.
I was feeling alone and almost desperate before hospice stepped in to help. I cannot say enough positive things about the hospice care my mother is receiving and I thank God every day for their services!