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Mom has been in hospice about a month...have not had any communication from hospice unless I initiate. I am there almost every day and have only seen a volunteer chaplain once...I was told nurses would check on her twice a week, social worker every week, etc. When I signed her up, I agreed to their offered complimentary therapies such as music therapy, pet therapy, massage , etc and have yet to see that happen. ...unless they come at night when I leave. AL is not providing activities either unless I transport mom to bingo, etc. Granted, she is getting very weak and may not want to participate , but it would be nice to know if they are at least trying. Every day I find her depressed and staring out her window. If you have a loved one on hospice , how much communication have you had with hospice agency ?

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Our experience was visits from the nurse two-three times per week, bath aide twice per week, one visit from social worker early on to document her wishes. There were some offers of "extras" most of which MIL was not interested in. I never heard anything about music or pet therapy or massages. No volunteers to sit with her. I suspect some of these things, such as lack of volunteers, were due to Covid (early 2022). We did find the hospice nurses to be very responsive when we had questions or needed help managing her pain. The phones were staffed 24 hours a day and you could get advice then or wait for a call back (or visit if necessary) from the assigned nurse.

It sounds like you don't live with your mother but stop in to see her every day. Does she mention any visits from Hospice or is she unable to remember things like that? My MIL lived with us while on hospice so we were always there when they came and we definitely spoke up when we had questions. I'm not sure how much communication they would have initiated with us if we weren't right there. If they are fulfilling the basics, that may be all you can expect.
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Hi tygrlly.

I’m enrolled in a 7 week bereavement management course, and now in my 3rd week of meetings, we’ve begun discuss ways that we can sometimes consciously or unconsciously divert our feelings about our losses by using attempts to release them using tools that don’t ultimately work.

Just last night, as I was doing my weekly homework, I ran across the idea that “anger” was on the list, along with several other recognizable distractions, like food, alcohol, shopping, too much TV.

Reading your comments it’s so apparent that you are angry, and you express it.
I thank you for that, because as I first read the comment, I didn’t immediately realize that I was angry for quite a lot of my recently deceased LO’s residential life.

My LO’s first experience with a hospice was VERY comforting to me, and that nurse was in contact every time she met with LO.

In her last contact with hospice, her residence was in and out of COVID precautions, and I was often there when she was bathed and changed. The care and concern I observed was meticulous, but “communication” was always brief and by word of mouth.

You have provided exemplary care for your mom. You are stating that you want to know if your mother is receiving the services that you (and she) were promised.

Here’s hoping you get the information you’re looking for without having to resort to any reactions that will be upsetting to you.
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tygrlly1 May 4, 2023
...I know that my anger at how unfair this seems for her to have to suffer through this is coming out, and how rare her disease presentation in the miuth and throat is....so I am doing my best not to take it out on my hubby and caregivers. If I slip, and I realize that I have, I quickly apologize. I just got back from Urgent Care for me...severe bronchitis flare ,for several weeks now..but I put it off because of mom.. paired with long COVID breating issues, not a good combination. But Dr also thought my being uable to breathe well was maybe also related to moms situation and that I may be also having panic attacks. My blood pressure and oxygen was so low I was close to being sent to the hospital ....but ok to,go,home with the understanding I will go there if things dont improve. I have noticed that these shortness of breath attacks are worse and lately happen frequently when I am leaving after visiting mom. Never made the connection before and wonder if others whose LO are in hospice experience this? I was given big gun meds so hope to feel better again. The bereavement class sounds like a positive step. Thank you , and Im so sorry for your loss, Ann.
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tygrilly,

It’s really hard waiting for a cancer diagnosis. My husband was diagnosed with prostate cancer. He was fortunate to catch it early. He had the choice of surgery or radiation. He chose radiation and is in remission now.

Will be thinking of you during this difficult time. Sending many hugs your way.
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tygrlly1 May 4, 2023
Thank you...
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Can you get hospice to be more assertive with the staff? They gave staff where my.mother was alot of direction. Once this is over you should definitely report the facility negatively. Are you able to feed your mother yourself at any times? I.am so sorry you are experiencing terrible unacceptable behavior at this stage.
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tygrlly1 May 4, 2023
Thank you all....Yes, I am there everyday, but mom is very weak and my visits are short...she likes shakes which I bring to her and I also have given her pudding...but I am currently in very poor health myself and am at my limit emotionally and physically..with a lot of post COVID breathing problems . Her wanting to try to eat occurs between her naps at random times.My brother refuses to help, visit or call , ( everyone tells me maybe he just cant handle it emotionally...but he has always been a mean self centered jerk that only cares about money, which mom is running out of) and my husband is currently being tested for prostate cancer....I feel like one of those silly putty faces we made as kids on comics and stretched to the limit! I dont know how much easier I can make it for the facility.Hospice is definately speaking up to the AL Director. What a shame that its so hard to get people just to do the right thing....
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Glad to report that my carefully worded e mails followed up with phone calls have improved things quite a bit. Moms lymphoma is affecting her mouth and throat and making it hard to eat because of being so sore. PRN more robust pain meds now being offered and I now get personal reports from hospice staff nurses after each visit twice a week. . AL staff still a work in progress ....I had a meltdown in the directors office after seeing how miserable mom was yesterday. I bought her an assortment of flavorful soft foods , with the Directors blessing, but the aides were not giving them to her. They dont even need special prep....puddings, yogurt , popsicles , and carnation breakfast in bottles. I firmly again explained to AL unit Director that watching my mom go through this was heart wrenching and stressful enough for me without worrying that she is not getting some nutrition because staff are not willing to walk a few extra steps to open a frig and put it in front of her when I cannot be there. I have insisted that it be put on her care plan and that I am informed if she refuses her special soft foods.
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NeedHelpWithMom May 4, 2023
I’m so sorry that your mom is struggling to eat.

This is such a difficult time for you.

Sending many hugs your way. Please keep us updated.
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I suggest that you talk to the Care manager of the Hospice Team and ask what is going on and get information as to when the Nurse is at the facility seeing your mom, ask when the CNA is there to give mom a bath or shower.
Some Hospice have Apps that can be used to communicate with the Team. They are secure. General Texting is usually not secure.
But you are entitled to answers to your questions. If you are not happy talk to the Supervisor and if that does not work you can contact another Hospice.
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tygrlly1 May 1, 2023
Thank you..I sent the mails so I can keep track of when I have contacted them. Her Hospice nurse CM contacted me as I did text her over the weekend.I dont have her email address ... She has been repsonsive when I have needed her,...there is a Hospice team meeting tomorrow morning and she will find out why communication re activities and medical condition has been so poor and get back to me.
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I cant see a person on hospice wanting to go to bingo or other activities outside the facility. Pet and music therapy yes. Sounds like hospice in a facility is just like hospice at home. They do the bare minimum and expect the family to do most of the hands on care and enrichment for the person.
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tygrlly1 May 1, 2023
I understand that. My dad was in hospice at home and mom and I worked with hospice and provided many cares. Mom still wants to go to bingo , even if she cant play her bingo card ( I do that for her) so she can see familiar friends from when she lived in Independent Living there. She asks for me to wheel her there when she is having a day when she is too weak to walk, and looks forward to it. She now lives in Assisted Living in the same community , The bingo and other activities are available and offered in the same facility for other healthier AL residents .Other AL activities geared to sicker and more physically impaired residents like mom and those on her wing are posted and are supposed to be offered and are not. Not even music or movies in their common TV area. Mom is paying over 7600.00 a month , and I do expect more than the " bare minimim." I provide daily companionship and love and physical help if staff is not available at that moment, but I am not trained to do hands nursing care so it is not just like hospice at home. If that was possible for her or myself she would be in her old IL apartment but needed to move to CBRF once POA was activated. She would not have been safe in her old IL apartment and received her terminal diagnosis after she was moved to AL and then hospice was brought on board. She has lived in this senior community and loved being there for 7 years and regards it as her home.They had been top notch until she had to go to AL , and now it seems like she is on an AL wing where people look out their windows, with no stimulation, waiting to die. The aides provide very good basic cares and TLC ,for the most part ,and mom and I thank them often and I bring in special treats to show our appreciation. Lack of communication about her medical condition ( the cancer may now be in her oral cavity and it hurts her to eat and swallow...) so it is hard enough for me to go through this and watch her struggling , scared and depressed and in pain without having to babysit the facility and Hospice agency) Communication regarding medical care and chenges in condition , and lack of meaningful activities even being offered , are my main concerns. This morning I followed up with emails to AL Unit Mgr , senior community director, DON, Hospice Director, and Nurse CM this morning asking for bi weekly nursing updates , monthly updates from hospice Medical Director , immediate assessments for ancillary hospice therapy activities and AL Activities assessment ( both of which was promised three weeks ago and never happened.) Not too much to ask for in my mind. Thanks to everyone on this site for letting me vent and reaching out ..hubby doesnt get it , and Im really the one left that she has. Its soooo hard. Looked into grief therapy group at our church , but it is only for after the LO has passed. This site has been a godsend for me.
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What a shame that you aren’t getting the service that you expected and deserve.

You are a wonderful advocate for your mom.

I wouldn’t hesitate to ask for clergy to visit again. Yes, they are busy but they should respond to you.

My mom’s hospice was extremely responsive to our concerns and my mother’s needs.

Best of luck in getting this situation resolved soon.
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tygrlly1 May 1, 2023
Thank you ....took action in writing this morning ...Fingers crossed. Will elevate to State Ombudsman if nothing changes.
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Ask the AL which hospice is the one most of their residents use. That'll tell you who works well with their staff. That's who I'd hire and did when my mom was on hospice in MC. It's also helpful because if their nurse is visiting someone else at the facility, your mom might get a visit piggybacked onto someone else's. Depending on how many clients they're serving the nurse could conceivably be there every day.

As for them calling you, what do you want them to call you about? At the very least they should be giving you an update on Mom's condition after every visit.

I'm a big advocate for putting your wants/needs into writing so it's really clear what your expectations are. Put it all down, send it to the hospice caseworker in an email and ask for some clarification on your expectations and what they're providing.

If they still fail to step up, fire them and hire someone else.
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tygrlly1 Apr 30, 2023
The hospice I hired is the one the AL uses and recommended! Very frustrating...Sending an e mail marked urgent tomorrow to all the "team" members. Will also contact State as the AL is not following CBRF regs ( as a last resort) if my concerns continue to not be addressed....am also going to see if Medicare has minimum requirements for Hospice to be paid. Again, as a last resort....do not want any retribution or drama... I am hoping that it is just a case of poor communication with me, and not neglect of duties . Mom is a poor historian due to her advancing Alzheimers amd would not remember if anyone was in to provide cares or a visit. Fingers crossed.
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Ours were always responsive, but then I didn’t expect them to hop to it right away when I called. The attitude of “I know yours is a hard job and I’m glad to be part of your team” was what I tried to convey to them.
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tygrlly1 Apr 30, 2023
Yes..that is the message I constantly give because I know it is a hard job. Even made them a huge Easter basket filled with candy and a thank you note. I am not expecting anyone to hop right in .but I think , after a month, I would have had some type of status update. I wait 2 or 3 days for an answer to voice mail, text or email...only one time have I heard back.I feel like Im on a team of one.
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Thank you. If circumstances were different she would be in
another aL any now. Im
documenting every time I have to
reach out to get basic info. Tomorrow will be requesting ,
in writing, a joint meeting with AL Mgr, DON for
facility and Director of Hospice.
Its hard enough to deal with
loved ones imminent passing
without people who claim to care not doing their jobs.😡
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You need to call the Hospice director and tell them Mom is not getting up for what she signed up for. The AL can tell u when they sign in an out. And as far as I know, they mainly visit during working hours. The Nurse needs to be on 24/7 call. If u are not satisfied, get another Hospice to come in.
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I had wonderful communication with the hospice nurse who was the main contact for me with my mother. She would call and or text and give me the updates on all her vitals. What you are describing sounds unacceptable and I would make calls and perhaps get a different hospice agency if possible.

The AL facility does not sound that great either. Can you speak to a director? Ultimately it is up to the resident to partake in activities but it would be nice if staff could make suggestions to residents. It may be that Covid affected the level of activities but it should start to open up. You really need to speak to a director to get better answers.

If your mother is receiving hospice is she still able to attend activities? Please reach out to get better assistance.
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