It is likely time for me to consider hospice to help with the complications of home care and to keep from having to call 911 when things get to be more than I can handle. My mother is very up and down with being ok and then being on the brink of a hospital trip. What if I need a facility in the near future? Will being on hospice make it harder to get accepted? She really does not have any major illness, just old and up and down with dehydration and UTIs. She is 96 and would be private pay with LTC insurance and her own $. We are fortunate with that part. I am not sure that I (and my husband) can handle all her needs if they get more difficult.
Get a needs assessment and start that insurance process. The sooner you start, the sooner she will be in and you can go back to being her daughter.
I wish you good luck.
Last week my husband, I and my mother all came down with a non-COVID respiratory bug. It hit my mother (and me) fairly hard. She started to get dehydrated. I was considering the hospital again. Instead, I was able to find a mobile Urgent Care that did a great job getting her feeling better with an IV and antibiotics and even doing a mobile X-ray to rule out pneumonia. She is much better but still coughing and very congested but I think she is on the mend. With her advanced age, I am thinking it is time for hospice, but also thinking that maybe my husband and I will not be up for this level of care at our home even with hospice support. So, hence my question: If I put her on hospice first, will LTC facilities shy away from taking her under hospice care? Will a facility be an option if I choose to go that route?
If I was you, I'd find out from the facility you're considering which hospice organization their residents use most. That will ensure that your mom will be seen by a hospice nurse the facility is likely familiar with already.
That's what I did when I put my mom on hospice. Granted, she was already in a memory care facility, but I went with a hospice company that was already servicing residents there. Her hospice nurse already knew the routines and the staff at the memory care, and they worked together seamlessly on my mother's care. in fact, during the time my mother was on hospice, one of the RNs employed at the memory care, moved over to work for the hospice company, and she was the nurse who was with my mother when she died. She had been working with my mother for 2 1/2 years already as the RN on staff, so it was kind of nice that a familiar person was there with her at the end.
2 personal cases
My brother had hospice at home for cancer but he had a bunch of friends who would visit. There was one friend who coordinated with the nurse and provided caregiver and she would give us all instructions on his meds plus she set up a daily planner so that each of us wrote when a med was dispensed. He was young so that he could have this many visitors.
My mom was in MC during Covid and on Hospice for failure to thrive, barely eating, spinal fracture, and getting weaker. Towards the very end, her hospice nurse got her ativan for potential assessed anxiety (ie. arm movements and restlessness without ability to communicate any longer) Since my visitation was limited, I was never sure if a nurse checked on her often enough. Her facility had the staff because it was a multi level place and I knew staff would spoon feed her offerings about an hour after all residents had eaten, but I just never knew. This was a top rated Medicare facility. No resident on my mom's floor ever got COVID. You need to remember that the assisting staff of PCAs may not have the knowlege base to know when a patient is having pain or anxiety unless they asked but my mom was past speaking.
Your mom's prognosis must be 6 months or less. Given her age and frailty, I doubt that a doctor would have a problem prescribing hospice care.
LTCs love hospice because it's less work for them medically (since they're not trying to cure her dementia or old age or chronic illness); a more comfortable client; and extra help in the form of nurse, social workers, volunteers, CNAS.
HOWEVER…insurance does not cover the "room and board" part of the patient's care if they are on hospice. That would be on the patient/family. The medical part is covered…the daily rent is not. 95% of hospice takes place in the home for that reason. That's why there are so many people in nursing homes who are not "allowed" to die…it's simply too expensive for the family to pick up the cost of the facility. That's why a 96 year old would get antibiotics every time she had a UTI or bronchitis…because they're obliged to try to cure your illness UNLESS you're on hospice.
As a volunteer, I visit my client for 4 hours a week. That's all I'm allowed by law. A CNA will come by 3-4 times a week, the nurse, once a week (might check in by phone). They will teach you to care for your mom if you need help with that.
The most common thing we hear from families and patients is, "I wish we'd done it sooner." From personal experience, my wretched FIL died recently in terribly pain and filth in a long, drawn-out process because he refused hospice or medical care.
They once had a cat who had a tumor in his eye. The cat was so old and frail, and I begged them to put it to sleep. My FIL said no, nature would take him and there was no need to pay the vet for that. He wouldn't let me take the cat with me. The cat died, starving to death, unable to walk. My FIL died the same way, and you know…karma reached out and slapped him. Can't say I was sorry one bit.
My LO was a hospice patient in a memory care setting for about 6 months, then was moved into LTC where she lived almost a year.
So she was in hospice care for about 17 months.
mom is back on Palliative care now.
In fact, some hospice organizations have ‘end of life’ hospice care homes that your loved one can enter.
My mom died in an ‘end of life’ hospice care home. She received excellent care from the staff.
If an ‘end of life’ hospice care home isn’t available in your area, hospice care will continue in another facility of your choosing.