When do you know to call in Hospice?

At least in New York State, hospice home care can be great and it can cause problems.

My first suggestion is keep in mind that enrolling in hospice is not irreversible. Many people eschew hospice because of its connotations. It can feel like giving up. It's not. It's just another service that might be optimal for your parent. And you can always quit it at any time.

Hospice visiting nurses are often great at addressing issues including pain management, wasting (extreme weight loss), and the psychological stress suffered by caregivers.

The biggest downside can be that joining hospice might trigger a reduction in home care services. In New York, at least, for the Medicaid/Medicare patients I treated as an RN, hospice was a "Medicare only" program. That meant that hospice could not bill Medicaid, and patients were limited to only the limited number of home health aide hours that their Medicare covered. Because Medicaid was so much more generous regarding HHAs, these patients often lost important services by joining hospice home care.

Research that issue with your doctor or a social worker. Of course, I don't know what insurance you have or even what state you live in. Just be aware that hospice can trigger some restrictive insurance issues-- But not necessarily in your case. I just recommend that you check it out.

Also, it sounds like you're handling this all on your own. I recommend that you look into getting an aide even if you don't go the hospice route.

The other issue about hospice is that you agree to forego any treatments that suggest an effort to cure or reverse disease. Be sure that you're not forfeiting treatments you want to continue using. I encourage you to speak with you doctor about this.

And finally (sorry to be so long-winded), joining a hospice program is reversible. If you decide you want to get more aggressive about medical interventions than hospice will allow, you can usually drop hospice at a moment's notice and go back to a more aggressive insurance plan. Again, this is something you might want to talk to your doctor about.

Good luck. It's a hard situation, but it really sounds as if your doing a terrific job with it.

How do you establish a connection or relationship with Hospice if your parent does not qualify at the moment. My mother can get around on her own but she does not want to eat and frequently says she will be glad when she is dead. We have a Gerontologist but honestly he is not being very helpful and is well honestly rude or curt in the way he speaks to me and I am her care giver and POA. Someone mentioned to me that I should have my mother evaluated for Hospice but I am pretty sure they would say it is too early for her.

We brought in a hospice doctor a year before my mother died and before anyone would even think she "needed" one. It was recommended so that a relationship could be built and so when the time came, we weren't bringing in a completely new doctor at the end. It worked out very well. The hospice doctor came every other month or so to visit with my mom and check her out. She worked in conjunction with my mom's long-time primary care doctor. When my mom suddenly DID need a hospice setting, we were all ready with an established relationship with the doctor and the hospice organization. So even though you don't see the end right around the corner, it's not a bad idea to establish the connection now.

We put Grandma into a Hospice Program after a 1 week hospital stay and then a 1 and a half week of VNS coming and assessing that she doesn't need full time care... Mind you, Grandma was hardly eating and sneaking her food to the dog when we turned our backs, barely knew what day it was, and needed to be dressed by myself, mom, or aunt. VNS kept dening care, at home Hospice care was a final option because we got 4 hours through Hospice and the assistance to bring in 1 privately hired aid. Grandma took a major fall and refused hospital treatment and passed away shortly after. She was 4 weeks and 2 days of being on Hospice, grandma declined rapidly and passed away peacefully at home. Our aids were phenomenal in preparing us for her final days, they told us it was coming and did everything they possibly could to make my grandma comfortable.

Some people can be on Hospice programs for years and some are only on it for a short time. Talk with your mother's doctors to decide if it's time for a Hospice program. The hospice program my grandma was on, allowed her to go anywhere, but she had to stay close to home incase we ran into a problem and she needed medical attention, if she left the state and was to be admitted to the hospital, she would be dropped from the program and our process would start all over. Ultimately on her own, she knew if she went to the hospital after this fall, she wasn't coming home and her wish was to not die in a hospital. Against the rest of the family's wish, we honored grandma's wish and made the last 4 weeks very comfortable for her.

It's case by case, but when I read about hospice care, most families said they saw rapid decline in their loved one. If in your heart you feel that this is the beginning of the end, speak with mom's doctors and care advisors and see what they say. Best advice would be if Hospice is the only other option left, go with an at home hospice care.

Because your mother's physician recommended Hospice, then please give them a call. They will send a nurse to evaluate your mother, and if she meets eligibility requirements, they will inquire about private or state funding, and submit the paperwork. After that, they will send a nurse, music therapist, and possibly volunteers to help you care for her. Hospice helps the family and the patient. Just pick up the phone and call your local chapter. Hospice was a Godsend for my mother and I. So much so, that my mother's condition improved and she was discharged, for now. Prayers for you and your mother ~

I just put my 96 yo mother into Hospice, because she needed extra care that the AL facility could not provide. She has gone down-hill suddenly over the last six months, and a recent trip to ER took too much out of her and me to ever do it again. She will have her own caretaker in the morning and the nurse will stop by once a week to check on her. My mother is wheelchair bound, has very little balance, is almost blind, and wears hearing aids. She is slowly approaching her limit. Her doctor had to recommend that she be considered for Hospice.