Decision to no longer hospitalize. Is that the same as deciding hospice/palliative care?

SummerHope: This is in the same vein as DNR.

I will add an experience I learned as my wife’s health declined. hospitals are not for the old or deteriorating. They are trauma centers and focus on immediate care. If you have a chronic condition or age related condition they can not and WILL not help. You are best to find a care home or inhome care. That is what I did.

Practitioner orders for life, sustaining treatment (polst).
It gives you the choice of a DNR plus options of full treatment, selective treatment, or comfort focus treatment. It also includes the option of medically administered nutrition. My mother is at home with a 24/7 caregiver and I have hers on her refrigerator . I have copies to go with her in the event she needs to go to the hospital. Each state has their own form and you can find that online to print/ fill it out and have your physician sign.

POLST is a great idea because you are being clear about choices. Palliative Care is a great option to help with this type of clinical decision making because they can help anticipate situations and guide you in how much may need to be done. It’s chronic disease mgmt. Hospice is for end of life comfort and care. Think of the order this way. PC is ongoing maintenance advice as you or your LO manages a long term dx. A POLST answers those situational questions/concerns/ decisions and hospice is providing comfort when treatment options are done.

Not necessarily
A person can be treated in a facility.
With Hospice you actually have a Team from the Hospice agency that will come in and check your LO. Weekly a Nurse would come and check vitals and check for any problems and order medications. A CNA would come 2 times a week and give LO a bed bath or a shower or bath and the CNA would order supplies. (Briefs, gloves, ointments, bed pads soaps,...) ((The Hospice CNA would take over what the facility CNA was doing as far as bathing, there can not be a duplication of service))
With Hospice you are also asked if you want a POLST (or DNR) signed. It is not required but a good idea. Without a POLST or DNR the facility and or the Paramedics will do CPR. (POLST also gives option for IV's and Intubation neither one Hospice will do) CPR on an older, frail person probably will not have a good outcome. Good possibility of broken ribs, cracked sternum, maybe a punctured lung the recovery from all this is difficult.

Given the option I would opt for a POLST and no trips to the hospital. And if the person is Hospice Eligible I would get them on Hospice.

When Mom enterd LTC this was not asked of me. I was the one that asked about criteria for sending to the hospital. I was told id a resident hit their head, immediate ER. If they fell and no one saw it, ER. If they fell and no head involved, then the resident was observed. If there were signs of pain or maybe a broken bone, then they were sent. In the 5 months Mom was in LTC she was not sent to ER. First 4 months in the AL, she went 4x. Why, because she said she was in pain after a fall. Of course she was in pain aren't you when you fall? I told them unless she hits her head, just observe her. If she still complains about pain later on, then take her to ER. It would be on me if found the fall was more serious.

I think it's pretty much pro forma, the same as asking about whether the resident has a DNR.