my elderly mom who is 77 yrs old had a major stroke on her right side 12 yrs ago. She has weeping legs and was admitted to the hospital on dec 3rd 2025 for a broken toe. After a week she went to a rehab and was there a month when she went to the ER for unresponsive for 4 hrs. and oxygen under 90%. She was in the hospital for a week then went to another rehab for a month and had a second stroke on her left side which was ongoing for 3 days at which time ER noticed it and stopped it. She was in the hospital for 2 wks. and was on a feeding tube. Then she went to rehab for 2 months at which time they told her she could eat and drink without feeding tube. While there she had a severe UTI with delirium so on Mother’s Day she was admitted into the hospital. While in a hospital room there she had a choking incident with aspiration and a tonic colonic seizure. Then when they sedated her so they could intubate her and she coded and her heart stopped for 3-4 minutes. She was put on a ventilator for 3 days at which time they put her in a regular hospital room. After 3 days they moved her to PCCU due to low oxygen levels. She was placed on High flow oxygen at 55%. She had been on it for 2 wks. They took her off of it this morning and put her on regular oxygen at 6 liters. She is utilizing the feeding tube still and her doctor has told us she has plural effusions in her lungs that are getting worse. She also has aspiration pneumonia and aspiration pneumonitis. And yesterday while still on high flow oxygen they wanted to put her on hospice. She has diminished mental capabilities but recognizes family. And has a DNR In place. We are confused she seemed better today but we got a call they want to put her in hospice or skilled nursing. Skilled nursing is not enough care for her.
I wish you peace, this is not easy.
With all your Moms problems I would go with Hospice. But understand what Hospice is. Its end of life care. The feeding tube will be taken out. Any life sustaining medications will be stopped. Medications for her comfort will be kept. Morphine and anxiety meds will be given to keep her pain free and comfortable. If you bring her home, family will be doing most of her care. An aide will come 2 or 3x a week to bathe her. They are there maybe an 1hr. You could request longer for time for yourself or to run an errand. You will be taught how to administer med. Nurse will come maybe 1x a week but should be available 24/7 by phone.
Why do you feel a Skilled Nursing Facility cannot take care of Mom? She could be placed there with Hospice in place. She would have round the clock nurses and aides. 24/7 care.
Even while in hospice, people can have periods of time (days or weeks) where they are better than previously. More alert, talkative, eating, moving around, better vital signs.
You can be in hospice in a skilled nursing facility, and I think even in a hospital. What hospice means is they stop aggressive treatment to try to cure whatever medical conditions and instead focus on comfort and making her time that is left as comfortable as possible.
Ask them at the hospital more about what hospice would mean and what the options are. Where could she go (not home). What meds and treatments would continue and which would be discontinued. Ask them what the best case scenario is if you continue aggressive treatment? What are the goals?
Ask yourself what she would want if you could tell the 45- year-old version of your mom what is going on with her now. Continued aggressive treatment, feeding tube? Or a more peaceful and natural scenario?
best wishes
Your mom is very sick and if hospice is recommended it's because her care providers feel that she doesn't have much hope for survival and that she will be dead in 6 months or less.
And I know that you don't want your mom to suffer needlessly as I'm sure she doesn't want to either.
Hospice will mean extra eyes on your mom and extra care and that she will be kept as comfortable and pain free as possible until she dies. You really can't ask for more than that.
And just because your mom goes under hospice care doesn't mean that she'll die soon. My late husband was under hospice care in our home for the last 22 months of his life just as an example.
I think it's important that you ask yourself what quality of life does your mom really have at this point, and is keeping her alive by extreme measures really worth it in the end.
Or is allowing her to die with dignity the better option? Tough questions, but ones that need to be asked.
I wish you well as you decide what is now in your moms best interest.
God bless you.
In all the medical detail you provided I didn't read CHF anywhere... weeping legs and strokes (among other symptoms) are usually associated with this condition. Feeding tubes impact quality of life for elders. Even with a feeding tube, patients can continue to aspirate saliva, stomach contents, or secretions.
I would ask her medical team what they realistically expect her quality of life and functional status to be in the coming months, and what benefits they believe skilled nursing would provide over hospice. Those answers may help you make decisions in her own best interests in the coming days.