My 90 year old mother has been in a SNF since suffering a stroke about a year and a half ago. She has advanced (most likely vascular) dementia and cannot walk (or even stand upright without significant assistance), but has no other serious health issues. About two weeks ago, somewhat to my surprise, she was admitted to hospice because she has been losing weight. She eats very little, maybe 20% of her meals, sometimes less. She has also experienced a more rapid decline in her cognition over the last couple of months. She has hated the nursing home she is in (though is much less aware of where she is now than she was at the beginning) and, even though it is very well regarded (and incredibly expensive), I feel that the care she is receiving there is not great. The nurses are mostly very good but the CNAs -- with one or two exceptions -- range from just OK to terrible. The physical environment is also very institutional and quite depressing.
It has now been suggested that I move her to a nearby hospice house. I toured it today and it's absolutely gorgeous. There are only 18 beds, the rooms are spacious and beautifully furnished, the facilities for both the residents and for visiting family members are amazing and the staff seems (from what I could tell) really attentive and kind. It's really like night and day. And it's slightly less expensive than the SNF. However, I am concerned that she might end up not qualifying for hospice at some point and then I would have to either move her back to her current SNF (assuming they still had a bed for her) or find another facility. I am willing to risk the upheaval that a move would likely cause her one time, but I am not sure I am willing to do it more than once. On the other hand, I really want her to spend the remaining time she has in more pleasant surroundings, with hopefully better care. And then I wonder if I am overly influenced by the beautiful facilities, which she might not even be in a position to appreciate.
What would you do?
So Split second you need to make sure you and the Hospice home are on the same page.
My mom moved into a lovely hospice care home and she received excellent care by the entire staff.
Research your hospice organization and see what the stipulations are. The place where my mom was had a time limit applied. Mom happened to die before she reached it.
I was told that we could have her case reviewed and that she would qualify for a renewal. The woman in the next room to my mom had to get a renewal to stay longer.
My mom was the same as yours, she barely ate a thing. It’s so hard to watch them decline.
Wishing you and your family peace during this difficult time.
I think you will find the Hospice Staff are just angels in human form.
The Vascular Dementia is one. Weight loss is another that would allow her to be re-certified, if she is sleeping more that can be an indication of decline.
If it were me I would transfer her to the Hospice home.
If it comes to the point where the discussion is that she is discharged from Hospice the Social Worker will help find a place, they will not just one day say she has to move there will be notice.
I am curious about your statement at the start that "2 weeks ago, somewhat to my surprise she was admitted to Hospice"
Were you involved in the Hospice discussion or did you just visit one day and they said mom was on Hospice? I would hope that they discussed this with you and that your meaning is that because she has no other health issues she was eligible for Hospice.
A person does not have to be a End of Life to be eligible for Hospice. And as long as there is a "documented, continued decline" a person can be recertified for Hospice.
However if one does outlive the usual 1 week actively dying protocol, I know that you can pay out of pocket for your loved one to stay there until they die. It sounds like that is what you're referring to for your mom.
My late husband was at our local hospice home twice, once when I was told he would be dead in 48 hours, and the second time for pain control, and both times my experience there was great. The home was beautiful and peaceful and the staff overall was terrific. It's just a completely different environment from a hospital setting, as it should be as people go there to die.
And though I know my husband didn't know or appreciate the beautiful surroundings of the hospice home, I certainly did, and that made a huge difference since I was there most days at least 12 hours.
So ask all the right questions to this hospice agency, and know that your mom will receive exceptional care while there.
I visit her every day (though I do not stay more than an hour or so) and the environment at the hospice home would certainly make that much more pleasant. I hate seeing her in the nursing home and, whether she notices her surroundings or not, I just feel like she deserves better.
Thanks again.
My mother passed away this past April in a SN facility and became under hospice care. I had moved her there in September 2022. She started receiving hospice in December after a hospital stay. I was happy with this facility after having moved her from another one which turned out to be a negative experience.
It was explained to me that this likely was the best choice because the only other true hospice facility nearby was for those who were considered actively dying. My mother's hospice experience was very positive as far as that can be. Her hospice nurse was both caring and communicative with me.
It is not clear to me if the hospice facility you describe is one that will consider patients who may remain on hospice for possible longer periods of time or for those much closer to the end. That would be first a major factor to consider. If you choose to keep your mother where she is and bring on hospice you might find that the added level of care is very helpful in the areas that you are presently unhappy with. I wish you the best with this difficult decision.