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My mother is 88 and I placed her in the NH on March 12th, the day of the lock down. Whew!
She was diagnosed in February when things were getting bad. Up until then she lived at home and I had caregivers come 5 hours a day.
She was having accidents and refusing to get cleaned up and wearing depends full of poop. She was starting to hallucinate and trying to leave the house for *appointments* The nursing home said to think of it more like palliative care after I freaked out about *hospice* they said Medicare would cover it. When is this usually used? Is this a sign that they feel she's entering the final stage? I don't talk to her much because its just long stretches of silence. The last time I did last week she said everyone from the *other schools came over*, she seems to be living in her grade school years. She was not a fabulous mother by any stretch of the imagination but I feel bad that she's in her strange alternative mind alone. Sigh.....

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I would take advantage of hospice care. Ask which organizations they recommend and start researching for the best one that you feel is suitable for your mom.

Best wishes to you and your mom. Take comfort that you are doing all that you can.

Don’t feel obligated to visit often if it’s too hard. Call the facility to check on her if you prefer.
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SoVeryExhausted Oct 2020
Thank you. Hospice is through Medicare. They will visit her in the NH. Just confused about Hospice. I thought it was end of life care.
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My MIL is in LTC. She got covid this May and after 4 weeks the doc suggested hospice. She recovered but still is on hospice even though she's 100% her old self. I think as long as she is covered (she's on Medicaid) they will do it. She gets more TLC and it's been good to her, just not sure how long it will last. She is not near death at all, just frail and bedridden because she refuses to get out of bed. Other than that, she jokes around and she remembers who we are. I'm sorry that your mom was "not fabulous"...you are doing a noble thing. May God bless you for it and give you peace in your heart.
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Typically the "rule of thumb" with qualifying for Hospice care is that her Dr feels she has 6 months left to live or less. That being said, my husband was under their care for 22 months before he passed away a months ago, so as you can see, ultimately God has the final say as to when He takes our loved ones home.

Being under Hospice care will give your mom an extra set of eyes on her and honestly being that she's in a facility the care will probably be better from Hospice than what she's receiving now, and it should give you peace of mind, that she's receiving great care, So really it's a win, win for everybody. Wishing for God's peace to be with you in the days to come.
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The best thing is to be there when Hospice admits her. Then you can ask questions and the Nurse will explain how it all will work. You should be able to contact a Nurse at any time. If the NH is still in lockdown, I would ask that the Nurse keep you up to date.
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Hospice is more "used" today even when death is NOT imminent but the only way they can get it approved for medicare is by saying that death is expected within 6 months. Many will answer you on this thread I hope, who have had seniors in hospice, approved and reapproved, for a year and more. But palliative and hospice do recognize that one is in the "final stretch" no matter how long the race. I will say this; I you are at all uncomfortable, don't do it. Hospice is much loved as it gets extra care; nursing homes and ALF often recommend as it is such a help to them. HOWEVER all hospice varies, and I will say that some can give too many medications, and too much, the idea being comfort comfort comfort, and it "may" hasten death (I would say almost never very much, though). You have time to mull this over. OR, better yet, insist that hospice speak with family, and see what THEY say. They, and your Mom's doc, at this time are your best guide on what to expect.
Do be comforted that hospice is (likely should not be) used when death is not imminent these days, just for the extra support. They will say "The doctor has to sign that given the circumstances he expects death within six months; but if you aren't gone we reapply.
All that said, you don't get hospice because you are wearing depends and have dementia, as you described. So what else is going on. What debilities are being seen that indicate death is near? Many people live demented and incontinent for many years; hospice is not usually recommended.
I would, were I you, be certain to FULLY discuss all of this with both hospice and your Mom's recommending doctor.
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I have read so much about how hospice says it's unfortunate that we got called so late. They have services that can be helpful for the patient and the family. The social worker and chaplain have been very helpful. My LO is in MC, but, they attend to her needs there. One factor is that the middle of the night ER visits stopped. The MC staff is to call hospice and me, before any transporting to a hospital. And, in fact, there will be no hospital visits, just keeping her comfortable as possible.

My LO has been on hospice for 2 years. She keeps qualifying because of her final stage condition. On AD scale a 7(f). Can't sit, can't hold up head. Can't speak. Bedridden with double incontinence, with regular urinary infections. I requested hospice evaluation when at least 3 doctors told me that she was very sick and wouldn't last long. That was over 2 years ago.

Here's an article from this site about it.
https://www.agingcare.com/articles/hospice-care-for-advanced-dementia-when-is-it-time-200580.htm
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Thank you to everyone that replied and the very helpful link! I have a much better idea/picture of what is happening. This group has been the biggest help to me and knowing I'm not alone is such a comfort. We are all members of a club no one wants to belong to.
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your name says it all- so very exhausted- I had the same name for years
Hospice will help you and your mom- as POA I didn’t allow certain meds and all Med decisions included my approval, hope you have medical powers.
The MC home wanted all control but don’t give them all the power, Hospice went to my mom’s defense always but we chose an excellent Hospice. More eyes with Hospice and nighttime sitters really made the difference. My sister and I visited for many hours daily, keep the eyes on the facility. Covid will make facilities so much worse by locking the “eyes” out . It is exhausting, then they die and it becomes sad. Prayers to you!!
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Another thing about hospice - they told me, over and over, that while their primary function is care for their patient, they exist to also provide support to the patient's family. Hospice was a blessing to all of us, not just mom. They provided me with support and advice, and often just an ear to listen and a shoulder to cry on. They advocated on behalf of my mother and me with her doctor.

If you can get a hospice evaluation, please do. You can always, always remove her from hospice if it's not working out the way you want; and they will accept her again later if and when that time comes. There's really nothing to lose by making the phone call.
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