Does being on hospice make it more difficult to move your LO into a LTC facility?

Hospice is not a problem in residential care facilities. I would talk with the case manager or social services during your mother's next hospitalization about this option. This person knows the local resources and the rules for dealing with hospice. Follow his/her advice.

It’s far better to be prepared by having hospice set up, rather than waiting until the last minute to acquire hospice care.

In fact, some hospice organizations have ‘end of life’ hospice care homes that your loved one can enter.

My mom died in an ‘end of life’ hospice care home. She received excellent care from the staff.

If an ‘end of life’ hospice care home isn’t available in your area, hospice care will continue in another facility of your choosing.

My Mom was placed on Hospice while in AL. The facility she is in do not turn down Hospice is actually beneficial to the facilities because of the care the patient receives. Mom got a bath three times a week, a nurse came once a week, the chaplain came and the social worker helped as well.

mom is back on Palliative care now.

jemfleming: No, being on hospice should not have a bearing on placement in long term care.

You can call a local hospice of your choice ; ask to speak with the clinical supervisor, share these questions with them; they will be glad to give you helpful information to consider. Also speak directly to her PCP about these concerns, needs, questions: they should be able to refer you to a Case Manager who is usually a licensed social worker who can help you also . You could also tell her PCP that you want her assessed by a hospice of your choice or their recommendation for hospice appropriateness for admit to hospice care; this will be a great information gathering time. Then it is up to you or your mother if she is still making decisions to decide if you want to accept hospice services. Most people find hospice care very supportive in the home and the many different staff that see you help in different ways; such as the Social Worker who can help with facility options etc or even hospice respite care ....

My mom was in LTC when we put her on hospice. They were wonderful. Provided a wheelchair that actually fit her, better bed etc in addition to all the added services. Don’t wait and don’t hesitate!

Hospice volunteer here:

Your mom's prognosis must be 6 months or less. Given her age and frailty, I doubt that a doctor would have a problem prescribing hospice care.

LTCs love hospice because it's less work for them medically (since they're not trying to cure her dementia or old age or chronic illness); a more comfortable client; and extra help in the form of nurse, social workers, volunteers, CNAS.

HOWEVER…insurance does not cover the "room and board" part of the patient's care if they are on hospice. That would be on the patient/family. The medical part is covered…the daily rent is not. 95% of hospice takes place in the home for that reason. That's why there are so many people in nursing homes who are not "allowed" to die…it's simply too expensive for the family to pick up the cost of the facility. That's why a 96 year old would get antibiotics every time she had a UTI or bronchitis…because they're obliged to try to cure your illness UNLESS you're on hospice.

As a volunteer, I visit my client for 4 hours a week. That's all I'm allowed by law. A CNA will come by 3-4 times a week, the nurse, once a week (might check in by phone). They will teach you to care for your mom if you need help with that.

The most common thing we hear from families and patients is, "I wish we'd done it sooner." From personal experience, my wretched FIL died recently in terribly pain and filth in a long, drawn-out process because he refused hospice or medical care.

They once had a cat who had a tumor in his eye. The cat was so old and frail, and I begged them to put it to sleep. My FIL said no, nature would take him and there was no need to pay the vet for that. He wouldn't let me take the cat with me. The cat died, starving to death, unable to walk. My FIL died the same way, and you know…karma reached out and slapped him. Can't say I was sorry one bit.

Your second post may indicate that hospice can be activated. I am sorry that you do not have a hospice LTC facility in your area but you can ask that question to the MD who will to the assessment. I am afraid that the poor SNF will neglect her unless you hire private staff while she is there. One problem I may see in the future is pain or anxiety medication that is ordered prn (as needed) because only a nurse can assess and dispense and they may not drop by often enough. Hospice will provide a visiting nurse but the maximum service may be once a day. Is it possible to ask her LTC agency if you can bump up the at home services? Again, these questions can be asked to the Hospice doctor who will visit your mom to make the assessment.

2 personal cases
My brother had hospice at home for cancer but he had a bunch of friends who would visit. There was one friend who coordinated with the nurse and provided caregiver and she would give us all instructions on his meds plus she set up a daily planner so that each of us wrote when a med was dispensed. He was young so that he could have this many visitors.

My mom was in MC during Covid and on Hospice for failure to thrive, barely eating, spinal fracture, and getting weaker. Towards the very end, her hospice nurse got her ativan for potential assessed anxiety (ie. arm movements and restlessness without ability to communicate any longer) Since my visitation was limited, I was never sure if a nurse checked on her often enough. Her facility had the staff because it was a multi level place and I knew staff would spoon feed her offerings about an hour after all residents had eaten, but I just never knew. This was a top rated Medicare facility. No resident on my mom's floor ever got COVID. You need to remember that the assisting staff of PCAs may not have the knowlege base to know when a patient is having pain or anxiety unless they asked but my mom was past speaking.

Hospice provides another set of eyes and hands for your mother's care. I can't think any nursing facility would have an issue with that.

If I was you, I'd find out from the facility you're considering which hospice organization their residents use most. That will ensure that your mom will be seen by a hospice nurse the facility is likely familiar with already.

That's what I did when I put my mom on hospice. Granted, she was already in a memory care facility, but I went with a hospice company that was already servicing residents there. Her hospice nurse already knew the routines and the staff at the memory care, and they worked together seamlessly on my mother's care. in fact, during the time my mother was on hospice, one of the RNs employed at the memory care, moved over to work for the hospice company, and she was the nurse who was with my mother when she died. She had been working with my mother for 2 1/2 years already as the RN on staff, so it was kind of nice that a familiar person was there with her at the end.

Hi. This is the OP. Couple things I should have added and a few responses to some replies to my post. First, thanks to all that have answered- it helps. I have already been using her LTC insurance to cover having an aide to help me for the past 2 1/2 years at my house. She would not be eligible for Medicaid at the present and I am not seeking advice on that. She has been unable to walk or even stand the whole time I have had her at my home. I use a Hoyer to move her to a chair for a few hours per day and change her every three hours or so. I have looked at LTCs in the area that are close enough for me to stay on top of her care. There are really only two - one with an average Medicare rating and one with a poor rating. Naturally, the one with the poor rating is closer. I avoided facility care up to now because of COVID, quality of care and cost. She is medically acceptable at the LTC level as demonstrated by the fact that the LTC policy is paying the home care benefit. As I said, we are blessed with that help. She has been in the hospital only once a year in the past two years, but each stay was for a serious condition. The first a combo UTI and (to my surprise) pulmonary embolism. She had just received her second COVID vaccine at that time so I am suspicious re the PE. She had no other signs of blood clots and no recurrence. The second was a bad UTI. Each time she has rallied and come back to being lucid and aware of herself and surroundings having some quality of life, but still in need of extensive help with toileting as a bed-bound person and general hygiene. Each hospital stay has been very taxing on her - especially the second. I do not think I want to put her through that again

Last week my husband, I and my mother all came down with a non-COVID respiratory bug. It hit my mother (and me) fairly hard. She started to get dehydrated. I was considering the hospital again. Instead, I was able to find a mobile Urgent Care that did a great job getting her feeling better with an IV and antibiotics and even doing a mobile X-ray to rule out pneumonia. She is much better but still coughing and very congested but I think she is on the mend. With her advanced age, I am thinking it is time for hospice, but also thinking that maybe my husband and I will not be up for this level of care at our home even with hospice support. So, hence my question: If I put her on hospice first, will LTC facilities shy away from taking her under hospice care? Will a facility be an option if I choose to go that route?

Were I you I might consider a visit to LTC facilities you are considering for the future and ask administration this question. In my own experience, in my brother's last illness, the ALF was thrilled he was using Hospice. They were glad of the extra care, extra monitoring, extra help; they coordinated with hospice in every way. This may not be the case for all facilities.

I wish you good luck.

I don't believe being under hospice care in a long term care facility has any bearing on being accepted....ESPECIALLY when paying privately. The facility should be very happy to take mom with or w/o the extra help hospice actually provides them with.

No it does not, in fact it can make it easier.

Get a needs assessment and start that insurance process. The sooner you start, the sooner she will be in and you can go back to being her daughter.

LTC needs to be assessed as medically necessary by a doctor. If one qualifies, then this is the first step in applying for Medicaid, for the other part which is the financial need portion. Usually issues like immobility and profound health issues gets one to need LTC, not just "old age", UTIs, dementia, etc. I would start by talking to her doctor.