Entering the 7th

Beachfan

Toolbelt,

I wonder if the physician acts as a sort of “silent partner” within the whole Hospice experience- -? My DH entered Hospice just 3 1/2 days before he passed. In that short time, I met with the Hospice nurse(s) on several occasions, the Chaplin, a bath aide, and a counselor. No mention of a physician, however, DH was administered morphine and Ativan, when he previously took no medication. I wonder if those medications required authorization from a doctor.

The important thing is care and comfort for your DW immediately; the rest will fall into place. Thinking of you.

Jeff86

I am saddened to hear Stewart, of your DW’s distress and the inevitable progression of her AD.

We have home hospice care for my DW. I talked with my DW’s nurse practitioner following a hospitalization and she agreed hospice might be appropriate and made the referral. This hospice organization is within the same healthcare system.

The hospice nurse makes weekly visits and, if medication adjustments are necessary, consults with the hospice doctor. All medications are covered by Medicare.

Whether it’s from hospice or not, your DW needs relief. Hopefully the MCF can provide palliative care. If not, then you do need assistance from hospice. I hope you and your DW get the support you need.

JeriLynn66

https://alzconnected.org/discussion/comment/188911#Comment_188911

Beachfan, you are correct.. primarily the hospice physician communicates with the Team. And yes, that physician signs off (approves) all medication orders.

easy23

The sign-off by an MD for my mother's hospice was the same as @Vitruvius. The hospice doctor gave the approval, not the primary care doctor.

Dio

TBE, are there other hospice companies in your area? I understand that each hospice company can have varying requirements and/or services. At least, this is the case here in CA.

toolbeltexpert

Dio I believe there are several hospices in our area. I am taking a wait and see attitude for a little while As you know things can turn on a dime. We had 2 good days and now it's a bad day. She didn't sleep last night till 5 am this morning so no breakfast, lunch isn't touched. Almost sleeping sitting up right now, she isn't in any pain that I can tell. I am sure if I insist things will happen.

M1

Peace to you both Stewart. I hope she's comfortable, that's the most important thing.

ButterflyWings

TBE - I am glad your pushing got assurances from the MCF that they will prioritize your concerns.

I'm with Vitruvius as one who has worked with 3 different hospices (2 for DH, 1 for a different family member) and the hospice evaluator (nurse) makes their assessment with the hospice's MD. I think the ad is just reassurance that protocols are followed to be sure hospice admissions follow regulations and are reviewed by an MD for the final decision.

Your initial concerns and instincts were right I believe - I don't think you were overreacting at all -- your DW has enough of the criteria that make her eligible for most hospices, in my view. At least based on our experience. I still don't understand the response of the MCF as if it creates more work for them if she's on hospice. Her care needs should be the priority and hospice brings extra support to your DW and to you, and in theory, to her facility. I'm with the rest of folks here who don't understand their resistance.