When is hospice the right choice?

Wouldn't it be absolutely wonderful if there were always a flow diagram we could follow which would leave us in no possible doubt about the right decision to take.

But perhaps what defines a difficult decision is that it is one without clear correct choices.

In the OP's case, I privately feel that the doctors' suggesting a feeding tube was deeply unhelpful. It would probably make it possible to prolong the gentleman's life significantly. But my - again, private and personal - view is that in his state of health, and in the light of his having previously signed a DNR which indicates that heroic measures were not something he was prepared to undergo, if there is one thing that is definitely NOT the right option for him, it's a feeding tube.

It would be comforting for the OP, perhaps, if her father is still able to swallow without aspirating, to remember that hospice will not prevent her offering her father treats. If he is hungry and able to eat, no one will force her to starve him.

I'm so sorry passingfancy

No to the feeding tube. It really is just a money maker for the doctor and hospital, plus many may not know, but it can be a way to contact sepsis. You (and he) will know when it is time to say goodbye.

" Pain medication stopped working for him and he was in severe pain most of the time." " severely weakened to the point where doctors say he will never physically recover or move again." Bedridden --combined with narcotic dependency-- both means high risk for pneumonia, blood clots and stroke, further hospitalization, skin breakdown...and it will be a severe challenge managing his bowels. Impaction can happen in days.  This will require digital disimpaction (a medical professional digging it out with their finger)..with routine laxatives. Remember these things and decide. I apologize for being blunt but that's the way it is. But you also have the option of PALLIATIVE CARE. Assuming he can't swallow without aspiration, and there is a feeding tube, but with the understanding he won't get better.  Feeding tube is palliative care. Without one you will need hospice care. If he's still in the hospital, ask for a hospital chaplain and discuss your options. Hospital chaplains are more knowledgeable than nurses and doctors when it comes to palliative care vs. hospice. DO NOT ever assume doctors and nurses know about these things.   The hospice facility must be medicare approved to provide palliative care. If you don't want to discuss it with a hospital chaplain talk to a social worker--but you have to ASK about your options..otherwise they will just follow what the doctor says. But a chaplain is your best bet palliative vs. hospice care options information.  Now they may last a long time with feeding tubes and bowel management--but a person won't last very long without fluids. 

Can you do hospice from home. Sounds like your getting close to the end. Take two weeks FMLA. No feeding tube.. Be there with him. You’l feel better in the end that you did what you could. I know it seems like a long time caring for them, but once they're gone, they're gone. 4.5 years here, and I can’t believe how much I miss them.

ShakingDustOff—Many of us are NOT CATHOLIC. I’m the furthest thing from Catholicism as a person can possibly get. So please stop telling people to talk to their priest.

Our situation is similar to TNtechie's story. Only the decision is for my husband's end of life care. We had discussed this much in advance, had the papers ready and signed, etc. I know what I have to do but am not sure I am strong enough. My goal is to make this time of his life as easy and comfortable as possible. It will be my last gift to him.

they will give you medicine like morphine to keep his pain level down you will have to give it to him if he is at home ..we fed my mom yogurt for a while then she could not have the strength to eat it & a little later she did not have the strength to take water anymore .so that is a good time to start hospice my mom was on hospice from 3-16 to 4-9 this yr .a year ago she weighd 149 pds then drop fairly fast that to is a time to think of hospice she was down to 1-7 in september or so also ask if they can give you a asthme inhaler i had one & used it 2 times a day or when her breathing was not right ..they call it rattling so she did not do much of that it is mucus caught in the lungs & they do not have the strength to take care of it ..it does work but i never told them .so also there was a time i thought to not use it & she passed over night .like she wanted so i would say to study your father & what he goes thru & help him make him confortable so he does not suffer ..good luck

Hospice is the right choice. I'm with you on the how emotionally hard the feeding tube issue is. I'm fortunate my mother made me her medical POA over a decade before she began having any problems. I had an opportunity to ask her whether she would want a feeding tube or not. A ventilator or not. For my mother the decision point was the remaining quality of life. She told me that if she was still living a good quality of life with the expectation of some more good days then she would want a _temporary_ vent or feeding tube. She didn't want either if it was expected to be permanent or if her future quality of life didn't include at least sitting up in bed enjoying a visit with family or friends. When she expressed these choices she had experienced a father with a DNR dying of a sudden heart attack during a congested heart failure decline; a mother who died slowly from kidney failure caused by end stage congested heart failure; and the death of a younger brother in hospice with cancer. She told me she didn't want to linger in pain, particularly if death was certain or nearly certain anyway. My mom has always been a fighter too. She takes daily walks to keep her strength up and hopes to see some of her great-grandchildren graduate from high school, but when the final decline comes she doesn't want it extended artificially. Your father signed a DNR so he likely has a similar point of view.

God bless and comfort you during this very difficult time in your life.

Fancy, you're not letting him starve to death. You're making perhaps the toughest decision of your life, on behalf of your father, and thus also probably the most important decision you would ever make for him.

I think the guilt would really be overwhelming if you didn't involve hospice, as he would continue to deteriorate.

Comfort yourself and know that you are doing the best thing you can by bringing hospice into the situation so that he can pass without further distress.

And take whatever time you can to relax and prepare to be available for him during his last days.

Based upon the information you have given, I'd say it is the right call.
They will manage his pain.

passingfancy, I know we rarely want to be the one to make any choices for our love ones when they are no longer able to make their own choices. There are so many "what ifs". We have to do what our parents had requested for situations like this. I realize not everyone is able to have "that talk" with a parent.

For both of my parents, the doctors recommended Hospice to which I learned as much as I could about this time in a person's life, what happens to the body and the organs, etc. I didn't want my parents to be in terrible pain, so I was thankful Hospice was there.

Hope you can make a decision that you are comfortable with. And even then you will be second guessing yourself, which is quite normal for us to do.