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I agree Grandma Once the criteria is met Hospice in home relieves the caregiver and provides expert care for the patient. Win- Win
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Reply to donnaann
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Lostmysparkle: Erratic and unsafe behavior does not make the individual qualify for hospice.
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Reply to Llamalover47
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My dad was on palliative care followed by hospice.

Palliative meant the doctor came to him. The doctor kept him on the kidney meds he was on but obviously no labs were done. Pt came and helped him to the point where he was able to go to the bathroom by himself, until one day he was found crumpled on the floor with no idea where he was. After another day of being delirious, the palliative doc suggested he go on hospice.

The focus totally changed then. For one thing, your contact is an rn, not a doctor. You likely won’t get new meds prescribed past the morphine/ativan/Haldol/seroquel combo.
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Reply to PeggySue2020
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In my opinion it is never to early to get a Hospice evaluation.
There are so many advantages to Hospice.
You get Support, encouragement, education from Hospice staff.
You get a Nurse that will come weekly. She/he will do a check on health status and order medications if needed.
You will get a CNA that will come 2 or 3 times a week to give a bath or shower and order supplies.
You will get all the supplies and equipment that you need. Briefs, either pull up or tab, ointments, gloves, wipes, absorbent pads...these will all be delivered to your door. the equipment a hospital bed, if you need a Sit to Stand or a Hoyer Lift that will be provided as well. Wheelchair, commode.
The initial admission would be 6 months but then there would be a recertification period and if they still qualify they would be recertified.
As long as there is a DOCUMENTED DECLINE the person may be recertified. I suggest that anyone on Hospice document everything! You may see a decline that the Hospice staff misses.
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Reply to Grandma1954
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PeggySue2020 Jun 5, 2024
Hospice tends to not order medications that aren’t morphine, Ativan, seroquel or Haldol. They may give you antibiotics and strips if there’s a future uti, but that’s it
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there is a palliative care and then there is hospice (in-home or at hospice facility).
It sounds like your loved one needs an evaluation by their PCP and a psych eval to determine what is going on.
Palliative and hospice may not be the proper care for the loved one.
Have you spoken with the PCP? Have you researched palliative and hospice care? It sounds like you have heard these terms and making presumptions about what they are about.
Palliative is generally for chronic illness with little to no turning back of the illness, like progressive COPD or progressive congestive heart failure, but is able to assist with their care from limited grooming, meal prep, mobility, etc.
Hospice becomes available when the loved one is in need of more attention and doesn't need to be the last 48 hours of their life.
Respite care is available for the loved one, especially when the primary caregiver is in of taking some personal time, whether a short vacation, change at workplace, health issues, etc
Please take the time to educate yourself about these truly wonderful programs and CALL your loved one's PCP asap for help.
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Reply to christinex2ri
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You’re talking about apples and oranges here. Erratic behavior and hospice care are two separate things.
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Reply to NeedHelpWithMom
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For me, the most beneficial aspect of Hospice was the guidance. Yes, the nurses and the bath aide were wonderful and having someone to come and do the showers 2-3 times a week took that off my plate and gave me a chance to change the bedding. But the rest of the 24 hours of the day you are on your own! For someone like me with no medical training and no experience with terminal illness, just having someone I could call and ask questions to was invaluable. My MIL was in quite a lot of pain at the end so we called them a lot, and they were always very prompt returning my calls, even on the weekends.

Someone whose behaviors put them and their caregivers at risk should probably not be cared for in the home, at least until they have been examined and stabilized with whatever medication they need.
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Reply to iameli
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christinex2ri Jun 5, 2024
when my mom progressed from Palliative care to Hospice in-home care, her team was so supportive and didn't care when you called for assistance. My brother and I were nervous when the script for morphine was given to aid with her congestive heart failure because we had weaned her off some serious meds that her previous TX PCP had ordered. Once she was back in RI and seeing her original RI PCP the opioids' were finally removed.
Once the Hospice RN explained clearly the proper use of the morphine, we including mom were able to relax. I think in the 2 months she had the morphine she may have taken 3 times. She nicknamed it 'her under the tongue med'. She did have oxygen primarily to aid her for naps and overnite sleeping. Her CNA was like family.
My brother and I are great proponents of Palliative and Hospice care and have reached out to family and friends with suggesting their loved ones be reviewed by their PCP and doctors for this care.
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My family’s experience with hospice is completely different than what was described above! Hospice is NOT just for the last 6 months of life when it comes to those with dementia. They have different qualifications for dementia than for other illnesses. My dad is not near the end at all (at least doesn’t appear to be to us or his hospice carers). He has a hospice nurse, doctor, shower aide, and chaplain visit him regularly. They regulate his meds and provide a lot of care for him. It’s been a huge help to my mom because he can be combative and difficult at times. Definitely call hospice and ask them to do an assessment. Not-for-profit and privately owned hospice groups are better than the large chains. If you’re accepted to one group and are dissatisfied with their care for any reason, you can apply to another one—if there are more in your area.
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Reply to DAB123
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Erratic and Unsafe Behavior do not qualify a person for Hospice.
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Reply to RedVanAnnie
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When behaviour becomes erratic and unsafe its time for placement and Medication.
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Reply to JoAnn29
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Hospice is end of life care, though a person may remain on their service for a long time, even years. It is not full time hands on care. For unsafe or erratic behaviors I’d seek an updated medical evaluation while noting these symptoms to the doctor as there may be meds to calm the behavior.
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Reply to Daughterof1930
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Hospice is end of life care. The life expectancy must be fewer than 6 months and usually that means a diagnosis that is consistent with death in that time.

More and more MDs are being encouraged to fudge things a bit to get a senior in for the "extra care" but in truth there IS very little extra care in this day and age. It is max of three baths a week, one RN visit (brief) and a phone call from clergy and Social Services. Also some equipment in terms of hospital bad, and then the GOOD MEDS.
That latter can be a bit of a tripping point with some families coming to the forum saying "I didn't know she was DYING; no one said she was DYING. They gave her MORPHINE. Now she is DEAD".
Hospice end of life care concentrates on comfort. That means that magic (used to be blue; is it still?) bottle of MS. Hospice nurses may be either more or less in favor of giving all the good meds they are allowed to. Sometimes this can cause respiratory drive to lessen in some elders.

It is much safer to say that Hospice is END OF LIFE CARE. Don't get it until you wish no further treatment toward cure, and until death is likely imminent within six months time.

Palliative care will often allow for better medications as the onus and burden of PREVENTING ADDICTION at all costs in now gone. Life is not expected to continue for so long that addiction to pain killers is much of a problem.
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Reply to AlvaDeer
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DAB123 Jun 5, 2024
Hospice doesn’t give full-time care but they still can be extremely helpful and give caregivers a break. A person with dementia does not need to be in the last 6 months to benefit from hospice. If you’re dissatisfied with the care you get from one hospice group, switch to another one.
I don’t know if this person’s loved one will be accepted by hospice or not but she should call and ask for an assessment.
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