Hospice

It is an acknowledgement that treatment of major illnesses with the goal of a cure is to be discontinued. Because there is no cure. That medications that bring the person comfort or prevent discomfort will continue. That other items needed for comfort will be provided. That there will be no more visits to doctors, ERs, or hospitals while on hospice. Terminal illnesses will continue unchecked.

So yes, it’s a major decision.

Do all family members need to be in on the decision? Well, that depends on the family. We just put my step-dad on hospice. Basically the AL nurse talked to me since I had the medical power of attorney. I agreed and then she presented the idea to my step-dad who 1) wouldn’t willingly give up control of anything and 2) was still competent to sign himself in. Mom (PWD) was aware but didn’t really understand on that day. We didn’t tell anyone else until after hospice had accepted him. None of the rest of the family have been involved in their care.

In our case, he’s had multiple terminal physical conditions for years that really couldn't be cured. He has reached the point where something inside him really can’t continue on. I don’t think putting him on hospice changed the trajectory of his life- it’s just acknowledging the truth about it. If we had waited one more week, he’d have no longer been competent to make the decision, and I’d have signed the papers.

Your family might be different - but you need to do what’s best for him even if a family member hasn’t come to terms with it. Only you know if you have the type of family that needs to be consulted ahead of time or informed after the decision is made.

I think the big thing is that treatment to get better or prolong life stops. Medication for high blood pressure, heart problems… would stop and medications to make the lo comfortable would be the priority. It’s my understanding that even if a bone was broken it would not be treated. Now could you stop hospice and treat the broken bone??? Not sure how that works. I think it’s a big deal. Some family members may have a hard time accepting a lo condition, wishing to keep the lo alive at all costs. You can’t just put a lo on hospice, they have to be near the end. Accepting hospice is accepting the reality of the situation and not all family members are able to do that. In this case I can see why a medical poa may not have a discussion with the rest of the family. It’s hard enough to make this kind of decision, compounding it with family who can’t see reality would be very difficult. But in an ideal situation with rational family I think family should be notified and even involved in the decision.

So sorry! I did not mean to give incorrect information.

It is a big decision, and you'll probably get a fight from your family. Before you put them on hospice make sure that they have a d.n.r and d.n.i. order in place. Oh it stands for do not resuscitate and do not intubate. That way you're bases are covered.

Wondering about the timing to start hospice? Do not want to give up on mom but also don't want to cause suffering (er visit etc)? She is not eating much anymore but is still walking (though not as steady), feeding self and talking ok? I feel like it is a gray area.

@Leanna Hospice will evaluate your Mom to see if she qualifies for the program. If she doesn’t then Palliative Care may be offered. Hospice/Palliative care are an added layer of support for comfort and symptom management. It isn’t “giving up”, .