I was told that if my Mother (who has dementia and has just gotten out of the hospital for pneumonia) goes on Hospice (and she is in a skilled nursing facility) that everything would be the same except that she would have a person come out to feed her and another person to come out to sit with her. Besides all that would be done as usual, in the nursing facility. Is this true of Hospice now days? Years ago hospice was totally end of life. They told me it would be more help. Can anyone clue me in on the Hospice that they are doing in 2019.

Hospice facilities' policies can vary, usually dependent upon state and federal regulations and are strictly regulated by Medicare. As a FCG (family care giver) volunteer with my local Hospice, I am familiar with the basics of their operation. This particular Hospice accepts patients in-home, in skilled nursing facilities, and in hospitals who are deemed by the patients' personal physicians to have six months or less left to live. The patients are regularly evaluated to determine if less or more time in Hospice is required. If the patient improves and no longer needs Hospice care and is terminated from the program, he/she can be reinstated if/when the health condition again deteriorates and the criteria is met. The skilled Hospice nurses work closely with and coordinate care with patients' personal physicians, keeping all actively involved, and supplement, but do not replace, the care provided by the doctors and medical staff, including the private physician(s). The "extra eyes" of the nurses, home aides, and volunteers are a plus in many ways, including monitoring the care being provided by the family and/or living facility, which can sometimes be substandard. Even if the patient doesn't want or need the full medical care provided by Hospice, often the family requests some of the services for the peace of mind it provides, knowing that they are doing all they can to ensure their family member is receiving the proper care.

Palliative care is one of the most important functions of Hospice. With the personal physician's knowledge, they are permitted to administer medications and drugs to alleviate the pain and discomfort many end-of-life patients experience that, by law, the regular physician is not.

It is always advisable to investigate each individual Hospice being considered as they are not all of the same caliber. The one I am associated with is 5-star rated in every aspect, and had I been aware of their services years ago when my mother was dying, I would certainly have enlisted their help.
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Reply to mozayic963
Harpcat Apr 7, 2019
Excellent and informative answer.
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There are guidelines for Hospice.
A person does have to have a Life limiting condition, be seeking no further treatment for that illness. Generally 6 months is a guideline but and this is a big BUT..
As long as there is a continued, documented decline a person can remain on Hospice. My Husband was on Hospice for 3 years.
With Hospice you and your Mom will have a Social Worker, a Chaplain if you want, a CNA that will bathe, dress and possibly feed your Mom. They will not be there all day but probably an hour or so a few times a week. (The bath that they get from Hospice CNA will be in place of the bath that the Nursing facility would have given they will not get more than the necessary baths)
You will also have the ability to request volunteers. Someone that can come in and visit, they can do no hands on help though. A variety or therapies can be requested like music, art, pet, massage (usually Reiki therapy)
Hospice is focused on Pain and symptom management so the entire goal will be to keep your Mom comfortable and to help you through what may be a difficult time.
If you know that name of the Hospice that will be helping your Mom go to their website and see what they are all about, see what they offer, see how they can help your Mom and your family.
I could not have done what I did for my Husband without the help, support, supplies, equipment and education that Hospice provided me.
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Reply to Grandma1954

When my mom was in nursing home, at one point hospice was recommended. We didn’t keep them for long as we quickly found out hospice care was an excuse for the regular nursing home workers, who’d been very good with mom, to back off care. We constantly heard “we’ll wait and let hospice do it when they come” when her needs were immediate. If hospice workers were running late, no bath for mom, things like that were common. We stopped it and all went back to normal. I know hospice is often good, but our experience within a NH was awful
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Reply to Daughterof1930

Hospice criteria changed a few years back. My daughter said a lot of her residents who had been there for years were put on Hospice who would probably live past the 6 months.

Be aware that some meds maybe stopped. She may not be sent to the hospital or go to doctors. Check this out.
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Reply to JoAnn29

We used hospice for my father also. He was in NH and his doctor was the medical director there. His health was rapidly declining & we asked for a hospice consult. We felt that the hospice staff responded more quickly to his needs than the NH staff ever did. The hospice nurse requested a private room for him (and family) after he lost consciousness. She bathed him, changed him, and gave him pain medication when she observed any facial grimacing or elevated blood pressure or pulse- when he was unable to communicate. The nurses took shifts around the clock and explained the reasons for everything that they wanted to do on his behalf. What a comfort!
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Reply to kjriggle
zeniworkman1964 Apr 7, 2019
Thank you so much for your comments. I hope you share your experience with the hospice website so others can be helped in thier time of need.
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My mom graduated out of hospice 2 times - alive. The last time she went to Heaven.

They will come in an evaluate her after 3 months, or something like that. If there is anything that may look threatening, they will let the doctor know, and they will evaluate you mom. If they do graduate her, you can ask for palliative care.
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Reply to MAYDAY
pronker Apr 7, 2019
I second the graduation twice back to regular care, because this happened with a dear family friend at her 80s. The third time in hospice took her out to her final rest, but until then she received extra care and no hospitalizations. This was about 2004.

My own mom received hospice only once, completed with her death; we could see her decline over 3 years in a well-regulated SNF and we knew she reached the end. Hospice told us there would be extra help for her and there was. Their care for our family was phenomenal after our mother died, with memorials monthly for those who'd passed, annually one year later, and numerous answered phone calls directly after the event. This was 2015.
Yes, that is correct. My mother has been determined/recommended by the NH staff right now that she doesn't need hospice at this time.
(This of course will change over time.) She resides in a NH that doubles as a skilled nursing facility. Hospice is still used for end of life care but it's also meant to help the staff at a NH keep an extra pair of eyes on the patient. Everything does stay the same, just with an extra pair of helping hands.
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Reply to mmcmahon12000

My experience with hospice early 2018 was that they encouraged discontinuing prescription meds while encouraging the use of pain meds. These pain meds hasten the dying process and serve to comfort the patient to death.
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Reply to castone
dinamshar9 Apr 8, 2019
I seem to think that also - as soon as we my father started the pain meds - which the nurse said would help his breathing - he went downhill fast. and the worst of it was - he never complained about having pain -
Hospice was suggested for my mother several times over the years. Each time I declined to pursue it because I knew she would bounce back quickly. Then when I knew she was not getting better, I had a very hard time getting her admitted. So it's not so easy to do, especially if there is no straightforward diagnosis like end stage cancer. My mother had moderate dementia and chronic intestinal blockages as a result of colon cancer surgery 30 years ago. She absolutely and adamantly refused the treatment for the last blockage so I knew she was done with living. Finally I got my mother on hospice and they were very helpful. She did stay on her blood pressure meds and blood thinner. She got better pain management which she'd been begging for. She died within a month.
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Reply to Rosyday

My mom has Dementia and was in the hospital for eight days in January 2019 being diagnosed with Congestive Heart Failure. Prior to this hospitalization paperwork was done for DNR and not to send out to ER unless it was something SNF couldn’t handle . About four weeks ago I received a phone call from the Nurse Mentor with the other medical staff telling me that mom is declining and it’s time to bring a Hospice in. I have to say the people from Hospice have been wonderful. Mom has good days and some bad days. Yesterday was a really bad day for her and I pray she doesn’t linger on.
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Reply to LisaNJ

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