Hospice - am sad - some questions

CaliforniaGirl-1 · June 10

Edited to make it briefer.

My LO/PWD is extremely elderly and her dementia has steadily evolved. She is not eating much and drinking less, is sleeping more, and is using a wheelchair more and more.

She has lost weight, is more tired and is very fragile. She seems to still know who I am but who can really tell?

A couple of weeks ago she mostly stopped eating but kept drinking her supplement. Then a week ago, she went to the ER for what turned out to be dehydration. The doctors at the ER raised the possibility of hospice given her condition and her age. They want to avoid a revolving door of ER visits, tests and needles when she obviously doesn't know what is happening and she seems to be progressing disease-wise.

Her own doctor has also recommended hospice at this time.

He told us it was possible that she would end up "graduating" hospice if she starts eating and drinking again and then going back on it

My questions:.

1- if she falls and breaks an arm - can she go to the ER and have it set while on hospice?

2- if she starts eating again or the supplements she drinks are enough to sustain her and they decide she no longer qualifies for hospice will she be able to get back on?

2- her doctor has a hospice provider he likes that has worked with her MC before and he has had good experiences with. Should we be evaluating others? The MC has some others they have used as well.

I like her doctor and trust him. But I would love to hear other people's experience with hospice of a very elderly PWD in MC.

MimiDIL · June 10

i can try to answer your questions, but it’s based on my state (Missouri) and the hospice provider who cared for my mom.

Yes, they would set a bone. It’s not considered “curing” your LO. It’s all about keeping your LO comfortable.
Unfortunately, once my mom was in hospice, she did not come off. But I have known of people being on hospice for extended periods of time. In my state, you can go back on hospice if you happen to improve and roll off.
I was very familiar with the hospice provider, so I was super comfortable with my choice. However, if you want to ask around, I see no harm. Do you know of anyone else in your area who has a LO who is or has been in hospice?

I wish you comfort and peace.

ARIL · June 10

The Hospice Foundation of America offers some suggestions about selecting hospice care:

https://hospicefoundation.org/how-to-choose-a-hospice-provider/

Although I have not yet walked this road myself, I do believe that hospice is all about care and comfort and would not leave your LO in pain. You can ask a provider specifically about what they do in certain situations, such as managing a broken bone. About going in and out of hospice care: I think this happens to a lot of people. A friend’s mother in Georgia was in hospice care, then out, then back in. Again, you can ask.

So sorry you are facing this hard time. I hope the next stages are peaceful and comforting.

JulietteBee · June 13

Hi there! I am an R.N and previous hospice nurse. My darling mother, also an R.N, has been diagnosed as a PWD. Thankfully, she is not at the point of needing hospice.

Hospice allows for hospitalization as needed for emergencies and comfort measures. With that said, a broken bone would definitely qualify for emergency care. Surgery can be done if it is ordered AND IF your mom was not made a DNR, AND her Healthcare Surrogate says that is what your mom would have opted for. If not, Hospice will manage her pain.
Patients on Hospice typically are admitted when they only have six-twelve months to live. If she is still alive & thriving, though they may discharge her from their care, they will readily readmit her if/when the time comes again.
Getting a second or third medical consultation is always appropriate.

Hospice - am sad - some questions

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