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My 88 year old mom, who had moderate vascular dementia before falling and breaking hip, now has advanced dementia. She still knows me,but is unable to feed herself and is not understanding or is unwilling to participate in rehab, to learn to stand and walk again. She also has congestive heart failure, AFIB, high blood pressure and carotid arteries are 70-90 percent blocked. She has a few happy days, but more and more sad days. Her facility is 1 1/2 hours away(they were only place to offer bed for rehab). She is agitated and refusing to take meds, eat or drink. She has a catheter, because bladder was not functioning due to anesthesia and pain killers. The facility is removing catheter on Monday, to do a void test and then she has an urologist appointment on Tuesday. Her urine output is not good and very dark, due to her refusing to drink. I do not know what to do. Is it time to call in hospice and who does that?

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In my experience it's never too early to call hospice. They'll come in, do an assessment, then tell you if her condition qualifies under Medicare for their care. I actually had to call them for mom because her condition was so deteriorated. They actually got her blood pressure under control and released her from their services. That was 5 years ago. However, that is unusual, but she was on the brink of stroking out.

They will explain their services and why or why not her condition qualifies. The clinical information helps a lot.
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In patient hospital, an excellent suggestion Countrymouse. The dark urine is worrisome. And IV fluids can be given.
Maybe they will order hospice to evaluate her, saving Worriedchild the added stress.
Sorry this is happening this way, Worried Child. Calling on hospice is not giving up.
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In patient hospital, an excellent suggestion Countrymouse. The dark urine is worrisome. And IV fluids can be given.
Maybe they will order hospice to evaluate her, saving Worriedchild the added stress.
Sorry this is happening this way, Worried Child. Calling on hospice is not giving up.
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She may be agitated because she's dehydrated. Ironically, that will make it difficult for them to get fluids into her.

I'm thinking back, here, to my mother with comparable co-morbidities and a fractured wrist. The next thing I want to say depends on how high you rated your mother's quality of life prior to the hip fracture, and how much of a battle you want to put your mother through. But if it were me, I'd want my mother back in hospital until they got the fluids and urinary issues under control.

Can you stay with her?
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Call Hospice..as a matter of fact call a few. Ask that your Mom be evaluated.
Just like any Doctor, or buying a car you want to get the best info so talk to a few to see if you like the people and what their approach is.
If she qualifies great if not you have the info and can call them again when conditions change.
My guess is she will qualify.
You could also ask at the facility where she is what their opinion of the Hospices that are in your area. I am sure that they deal with CNA's and Nurses from several.
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This is very sad.

When my mother's hip broke and surgery was not an option, the hospital suggested hospice, and did not expect her to live through the week. She returned to her nursing home and we did order hospice care. Three months later they discharged her from the program because she improved dramatically and was no longer expected to die soon.

So, from our experience, I can't see a downside to asking for a hospice evaluation. If your mother decides to eat and drink and starts to improve hospice won't interfere with that. Meanwhile she will get extra attention, equipment, and drugs to calm her agitation and any relieve any pain she might have.

You can ask your mother's doctor if he or she thinks it is time for a hospice evaluation. Hospice has their own doctor who can also make that evaluation. If there is more than one hospice service available to you, you can select the one you prefer and call them.

At the urologist appointment ask what the prognosis is for Mother's improvement and recovery. Of course this addresses only one of her conditions, but since that appointment is set up, you might as well start there.

My heart goes out to you. I have had the hospice experience with both my husband and my mother, and I know how hard it is to face that a loved one is likely in the final part of their journey. I have no regrets in either case.
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