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Also, what other care should be provided legally? She's been in the hospital since June 4th and they want to put a feeding tube in her stomach and then move her to a nursing home. It is clear to the entire family that she is fighting to live. She responds to everything we say and do. She cannot speak except to say yes and no but she nods and shakes her head, squeezes our hands, moves her feet and legs. She also cannot open her eyes but has cried (had actual tears) when a certain relative came to visit. She also holds, pets and waves a stuffed animal. The hospital has a stroke floor but would not put her there because the stroke was not diagnosed until after she was admitted. She is currently only receiving physical therapy, and has a feeding tube through the nose. Our family wants her to be placed in rehab after she is discharged from the hospital.

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except she already has a nasal feeding tube and I didn't see anything about them actually trying to feed her, as in even doing a swallow test, which they did with my dad and he wasn't able to; he just choked but I don't think they mean "writing her off", as in getting ready to die so why not calling in hospice, which I know thinking is changing on that, or at least as they call it palliative care, although in theory they'll often use the two terms interchangeably but either way not everybody I on board with that yet, so might be something to check into but don't think then she could go to rehab, which is what the family is wanting
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If they want to put in a feeding tube they either 1) have evidence that she is aspirating (the swallowing muscles can be effected just like the other muscles in the body which can cause food to go in to the lungs), or 2) is not taking in enough to survive. If they were "writing her off" they would recommend hospice and not put in a feeding tube.
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I think that's what you're dealing with, the 10 day thing; seems to be a new hospital thing; that's when they started pushing us to do something with my dad, which in our case didn't have a problem with but he was older and showed no signs of fighting to live; not sure what to say because not sure how to get a 2nd opinion in the hospital without transferring her somewhere else, which can also be difficult but I agree if they're wanting to put a stomach feeding tube in could mean they're writing her off, although not entirely sure, went through that with our granddaughter, but could mean something different on that end of life; know they told us it was because she was aspirating when they would try to feed her, which they had begun to do; she had a nasal feeding tube, but they haven't even tried to feed your mom, have they? what does the stroke floor at the hospital do? that's she's not having done with the pt she's getting now?
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Feeding tube .....if you think she has a strong will to keep going, I would avoid have the tube placed. The whole feeding cycle of grabbing fork/spoon, moving it about to get food, then the action from plate to mouth, then chewing & swallowing is a whole set of cognitive abilities that you want her to do. If you have enough family to do a dining team get that organized. The hospital (like the NH) has a set meal schedule and if they don't eat in a set time frame then tray is removed. Now her MD can write orders for "assisted feeding" and for " mechanized food".

For my mom, she fell & shattered hip from pulling her wheelchair at the NH she had been in for about 2 years. Now she could have had feeding tube but her advance directive stated no feeding tube. Instead the medical director wrote orders for assisted feeding & mechanized food, so the tray delivered by dietary would have been either diced for veggies or pounded thin then cooked and diced for proteins AND a CNA would sit and help mom eat as needed. After the first month, 1 meal a day would be a sandwich & sliced fruit as she could hold it. Now all this meant everbody - docs, dietary, nursing, cleaning staff - was all on the same page to have this done.

My thought and not to sound harsh, is that the MD if he is really pushing the feeding tube placed, well he has written off your mom. If he is balking at writing orders for rehab with both PT & OT, he doesn't think she is a survivor. You are going to have to do whatever to get her eating and get a second opinion to get rehab ordered. For foodstuffs, get toddler foods - all kinds of new varieties available now. Plus their shelf stable and she likely can eat most of a jar. Also often grocers carry birthday party size goodies ( like a box of a dz mini sherbets or mini lava cakes). Assisted feeding will be quite messy till you both get a rhythm going so bring a towel or pillowcase to drape around mom and wet wipes. For my mom day 10 after fall was the turning point for recovery. Good luck & keep your energy going.
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The problem here is...if a bed is available. Medicare won't payfor the hospital if they feel all has been done.
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She won't qualify for very long because of her condition unless she suddenly gets better which can happen with stroke patients. They will skill her for nursing care and therapy but I am not sure for how long. Be sure to check all of the facilities out on the nursing home compare site. There are some great ones but there are also some really bad ones. Have the social worker at the hospital make a referral after you have gone and checked some homes out. Go at odd hours like early morning and late at night. Get the real picture. Good luck.
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If she does get rehab, u can have her evaluated for longcare nursing. Easiest way to get themin a nursing home.
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When u are in the hospital, upon discharge a Social Worker will come and talk to the patient or family member. At that time they will tell u what they feel the next step will be. Only a doctor can recommend rehab if he feels its needed. Homecare too if u want Medicare to pick up the tab. Medicare only pays 100% of rehab for 20 days. The next 80 days only 50%. Hopefully she has a supplemental to pick up some of it. Feeding tube doesn't sound good. May want to ask about Hospice.
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