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Mostly Independent
Your loved one may not require home care or assisted living services at this time. However, continue to monitor their condition for changes and consider occasional in-home care services for help as needed.
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She is in a memory care facility, but has developed agitation, aggression, and incontinence. She has no interest in using utensils at mealtime and often eats with her fingers. She has been checked for a UTI.
She is eligible now. I just did it for my mom who is in the same stage. If she is still living in the next 6 months, they just re-certify. It will help you immensely with her care.
Hospice can be very helpful. But in most states, the patient must have a life expectancy of six months or less. You'll have to ask a doctor (preferably her neurologist) if she qualifies. But the symptoms you describe don't necessarily mean that she's within six months of death. Many people w/dementia and the proper medications live for much, much longer than this. Some people hasten the process of qualifying for hospice by removing all medications that could keep them alive (or their health care POA authorizes this). If she has an advanced directive, what does it say? If it says she wants to be kept alive by all means, you cannot act contrary to this. If it doesn't have one or it is vague, talk to her neurologist. If she's member of a church, mosque, synagogue, or temple, talk to one of the clergy there. They'll advise you about what's ethical and consistent w/her religious beliefs.
If I were you, I'd discuss with your mom's MD. I believe they refer a person to a hospice (although you might be able to do independently). - Be sure you understand what Hospice does / their objectives (comfort care, not keeping a person alive).
In my experience:
* When my friend/companion was in a nursing home, the MD there referred him so he'd get more care. * They really help(ed me) a lot to carry some of the load. Although... I have worked with a few different Hospices locally and all of them are different in how ... reliable they are / communications, experience. * Know that they offer grief counseling when needed for the person closest to the departed. They helped me with a client and then my friend years later. I believe they also offer grief groups. _____________________________ With what is going on now with our government / funding non-profits / support of our aged and disabled, we never know what services will be available - or for how long. _____________________________
It is clearly worth a consult - for you to assess how / if Hospice could support your needs and your mom's behavior. I know this is very difficult on you, and the facility. (My client was referred to Hospice while in a lovely facility... she no longer had to make trips by ambulance to the emergency room ... go through at that ... plus she didn't know what was happening to her during these medical crisis and she was alone with strangers at nights/middle of the night.)
Hospice can be a blessing in disguise. I am sure you'll get a variety of experiences / responses here to help you decide how to proceed.
You don’t need a doctors referral for hospice. They can come anytime to evaluate and then a doctors order to admit to hospice is needed but it can be the medical director. They will reevaluate periodically and if there is no evident decline , they will discharge but if decline occurs , even slowly, they can recertify
As said, having Dementia ismot a reason for Hospice. The agitation can be taken care of with Medication. Needing to be sppon fed can be done by the aide. None of these things needs Hospice. Their staff does not feed the client. In a home setting with Hospice the family takes care of the patient. In Memory care, the aides feed the resident.
Hospicebis endnof life care. With my Mom, she could no longer swallow and her body was shutting down. For herbit was comfort care till she passed.
Hospice has government guidelines by which they must follow before they can sign someone up.
We self referred (twice) to our local hospice. An RN came out and made the determination of whether Mom qualified. This was approved by the hospice MD back at the office.
My Mom was using her fingers to eat food, and sometimes missed her mouth. She had a hard time swallowing and she could no longer take pills. In fact, the day before I called hospice, she had another UTI, however, refused to allow anyone to collect urine. She was running a fever and was in pain since she couldn't swallow nor want to swallow her pain meds.
When I called hospice, they were able to "give" her some antibiotics and pain meds via suppository to get the fever down. However, she still would not eat or drink because she didn't know how. She was hungry, however her tongue would push the food back out. Regarding pain, it was still there and they upped the dose until she was at least able to sleep. She died about 2 weeks later.
It was agonizing to watch as I didn't know how to make her feel more comfortable. No matter what I gave her, her tongue pushed it out or she didn't like the taste of the food or the liquid. She kept on trying to get up, however, was too dizzy to do so.
Those last weeks before death were really torturous, for both her and I. Thank goodness it only lasted 2 weeks.
We recently had an interview with hospice care in Arizona. We were informed that in order to qualify for hospice based on an Alzheimer's/Dementia diagnosis that our Dad had to be non-verbal for a 24-hour period and incapable of walking. Our Dad has been in Memory Care for 14 months and he in NO WAY meets those standards. However, our Dad also has heart failure, and based on that diagnosis, he DID qualify for hospice care and it has been very helpful to my sister and I to have more people checking on him and providing the care/supplies he needs at this point in his life.
My experience is to be eligible for hospice you need to score at 7a or above on the FAST Scale. https://www.compassus.com/healthcare-professionals/determining-eligibility/functional-assessment-staging-tool-fast-scale-for-dementia/
Very sorry for your sad journey. Your mom needs to be diagnosed with a terminal condition approved by both the doctor and hospice care. My mom had dementia, but was approved with Hypertensive Heart Disease. That qualified her for coverage through Medicare.
A medication to help calm the agitation and aggression would be a big help. Talk with her doctor to determine if hospice services might be appropriate, but having used hospice, I’d caution you not to overestimate their help. Hospice is wonderful for providing supplies, advice, and good medications for comfort as end of life is approaching. They are not good for hands on caregiving.
Hospice is end of life care. A physician in care of Mom must attest to the Federal Government (who pays for Hospice) that your mom has in their professional opinion fewer than 6 months to live.
Having dementia and undiagnosed problems doesn't qualify someone for hospice. Do speak with her MD.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
I believe they refer a person to a hospice (although you might be able to do independently).
- Be sure you understand what Hospice does / their objectives (comfort care, not keeping a person alive).
In my experience:
* When my friend/companion was in a nursing home, the MD there referred him so he'd get more care.
* They really help(ed me) a lot to carry some of the load. Although... I have worked with a few different Hospices locally and all of them are different in how ... reliable they are / communications, experience.
* Know that they offer grief counseling when needed for the person closest to the departed. They helped me with a client and then my friend years later. I believe they also offer grief groups.
_____________________________
With what is going on now with our government / funding non-profits / support of our aged and disabled, we never know what services will be available - or for how long.
_____________________________
It is clearly worth a consult - for you to assess how / if Hospice could support your needs and your mom's behavior. I know this is very difficult on you, and the facility. (My client was referred to Hospice while in a lovely facility... she no longer had to make trips by ambulance to the emergency room ... go through at that ... plus she didn't know what was happening to her during these medical crisis and she was alone with strangers at nights/middle of the night.)
Hospice can be a blessing in disguise. I am sure you'll get a variety of experiences / responses here to help you decide how to proceed.
Gena / Touch Matters
Hospicebis endnof life care. With my Mom, she could no longer swallow and her body was shutting down. For herbit was comfort care till she passed.
We self referred (twice) to our local hospice. An RN came out and made the determination of whether Mom qualified. This was approved by the hospice MD back at the office.
When I called hospice, they were able to "give" her some antibiotics and pain meds via suppository to get the fever down. However, she still would not eat or drink because she didn't know how. She was hungry, however her tongue would push the food back out. Regarding pain, it was still there and they upped the dose until she was at least able to sleep. She died about 2 weeks later.
It was agonizing to watch as I didn't know how to make her feel more comfortable. No matter what I gave her, her tongue pushed it out or she didn't like the taste of the food or the liquid. She kept on trying to get up, however, was too dizzy to do so.
Those last weeks before death were really torturous, for both her and I. Thank goodness it only lasted 2 weeks.
A physician in care of Mom must attest to the Federal Government (who pays for Hospice) that your mom has in their professional opinion fewer than 6 months to live.
Having dementia and undiagnosed problems doesn't qualify someone for hospice.
Do speak with her MD.