Palliative Care - UPDATE

Kay82

My mother is 90 y/o and I (her daughter) have been living with her since June 2022. She has been showing signs of dementia since her husband (my father) passed away from dementia in Jan. 2019. I think the trauma of living with him (long story - mistakes were made by her & my sister) accelerated her condition to where we are today.

Last week she fell in her bedroom and did not suffer any injuries, I feel this occurred because she is eating & drinking less. In the conversation with her doctor about the fall he ordered blood tests as I stated concern regarding her health & the possibility of a UTI or other related infection. I had stated to the doctor I was unable to obtain a urine sample. The blood was drawn & the report showed no presence of infection. He suggested giving her cranberry juice - that has not gone over well, I will keep offering it though.

I called the doctor's office yesterday and talked to the receptionist & asked her to give the doctor a message. I asked if it is possible my mother could receive palliative care. Unfortunately as of this evening I have not hear from the doctor. I plan to call the office Monday for any info.

Has anyone had any difficulty getting palliative care approved by the insurance company - Medicare? I am concerned that insurance will not pay for it.

UPDATE - I called the dr's office this morning and added more info to my message left last week Thursday. I told the gal that I felt my mother needs a wheelchair and pain management. As of tonight the doctor has not called back. He won't be calling tomorrow as the office is closed Wednesdays. Consulting with my brother & his wife tonight as I feel our next best move is hospice.

M1

Kay, not sure what you are looking for with palliative care, but she might qualify for hospice and there is no harm in asking. You don't need a doctors order, you can just call a hospice agency yourself and ask for an assessment.

Kay82

I was unaware that a family could call in hospice. I thought of palliative care as a step to bringing in a medical professional for an assessment. 2 attempts for a home health care aide were declined by my mother.

Emily 123

Here you go...

https://www.nia.nih.gov/health/hospice-and-palliative-care/what-are-palliative-care-and-hospice-care

harshedbuzz

@Kay82

I'm sorry you find yourself in this situation. Is it difficult to get mom into a medical setting to be assessed? Is she generally difficult? You say she has a history of rejecting home health; was that for her or your dad? Home health is an umbrella term-- did you try to bring in PT, CNAs, wound care or something different.

Palliative care is often complementary to traditional care to improve quality of life with a major illness. That care isn't always brought to the patient; often it's like any other medical appointment. This can vary depending on what you want for your mom and even where you are located. There seem to be fewer resources for palliative care. Some agencies that offer hospice offer palliative as well.

As dad approached stage 6, he saw a gerontologist who took a more palliative approach to his care. In his case it was more like a hospice-lite kind of care. We went through his medications and stopped some of his health maintenance meds-- BP med, statin, metformin (mild T2D-- med gave GI side effects). We kept his mood and COPD medication to prioritize how he felt.

I agree, I'd call for a hospice evaluation. Even if she isn't accepted, they can tell you what to look for in terms of timing the next evaluation and may have information on palliative in your area.

HB

PS I'd continue to try to get a urine specimen. My mom (who doesn't have dementia) had a rapid onset of clumsiness, a fall, BP issues and change of mental status over the summer. Her PT seconded my opinion to go to the ER when her PCP couldn't see her quickly. They weren't quite sure what was going on and ran all sorts of tests. The blood work came back first (I was checking the portal on my phone) and was unremarkable. The urinalysis was posted later and was not. My local lab will give you a nun's cap to use with a toilet or commode.

Once mom's UTI started to clear she bounced back to her usual self.