My dad, 94, in AL with not much other than congestive heart failure being medically wrong with him. He's still in fantastic spirits. He gets around in a wheelchair, mainly because he stopped getting PT (didn't want it anymore, which I get). He refuses to sleep in his bed (I've purchased 4 dif beds, none were to his liking), so he sleeps in his power lift chair. At 94, I figure he gets to do whatever he wants. I was curious about hospice. When I asked the nursing coordinator at his AL place, she said he would be a candidate, and Hospice swooped right in and are taking care of him now. At first, I thought Hospice was for people who were, well, on their death bed with just a few days to go. Has something changed??? Thanks.
Your dad sleeps in his power lift chair because CHF or congestive heart failure causes a build up of fluid in the lungs and that makes it uncomfortable to sleep while lying down.
Cyber hugs to you as you navigate these difficult times...!
Jeanne, if Hospice is sending an aide for bathing, then the AL doesn't need to do it. If u have been paying for it then u shouldn't have to now hospice is doing it.
While hospice does have to be "ordered" by a physician and a patient has to be "hospice worthy" to meet the criteria (which may vary in some States), they do not have to be actively dying. In my opinion, having a good hospice care in place early is a wonderful blessing to the patient and to the family.
Our hospice is completely covered by Medicare. Our understanding is that he will be evaluated in 90 days, again in another 90 days and every 60 days thereafter. If he continues to worsen, he stays in hospice. Some people improve and they no longer need hospice.
Like others have said, we have a nurse who comes twice a week, an aide who bathes him (in the bed now) 2 or 3 times a week per your request. They have a chaplain and a social worker. I was especially happy about the social worker. She helps with paperwork (DNR, Medical Power of Attorney, etc.). Also, I’ve been so concerned that the time may come when I can’t physically take care of him. So the social worker is there to guide me through options and help that way. The nurse takes care of all necessary meds, incontinence supplies—everything is delivered to the house. We don’t have a hospital bed yet, but may need one in the near future. Oh yes, the social worker has a program where volunteers will come over so you can get out a bit.
One more benefit Medicare covers is if you need or want to go somewhere or just need a break, they will pay for a 5 day stay in a facility. I think it might be every 3 months, but not sure. I might like to take advantage of that to go see grandkids, but my husband doesn’t want to leave the house! So we’ll see... hospice has been great so far.
Your dad couldn't have been transitioned to hospice care without someone's signature. If your father is of sound mind, he may have had a discussion with his doctor and signed the papers. Or, maybe he isn't as sound of mind as people think and he signed the papers without really understanding them. Or his medical POA signed them (hopefully after talking to him). Have you had a direct conversation with your dad about how he got to hospice?
Hospice actually takes on many forms now. It's most often used for people in the last 6 months of their lives, but people have been in hospice for up to a year or more. People go in and out of hospice based on prognosis. It's also used as almost a respite tool.
Talk to your dad or whoever is in charge of his medical care.
As long as certain conditions are met a person can qualify for Hospice.
A life limiting condition.
Getting no treatments for THAT condition. (This means if something comes up like an infection that can be treated, but in your case his CHF can not be treated)
A documented, continued decline.
Personally I think Hospice is wonderful. And unfortunately people do not take advantage of it. For someone that is in the home you will get help in every week sometimes several times a week, a nurse will come to see the patient, you will have a Social Worker, a Chaplain if you wish and most Hospice will have volunteers that can come in and sit with your loved one while you run errands if there is no one else available. You will also get all the supplies and equipment that you need. I would not have been able to do what I did if it were not for the AMAZING and WONDERFUL Hospice team I / we had.
For all of these reasons, my husband and I have a little more peace in our lives as caregivers. Mom is bedridden and hospice care has been a true blessing. Mom completed her first 90 days and they had to do a blood test to see if she is still ill enough for services. She willingly held up her arm and said take my blood! LOL! They will need to do this at 90 days, 180 days and then 60 days thereafter, but the serves are indefinite. If you are happy with the company, count your blessings for the help. IF you are not happy with them, look for another company. There are many out there, even in small, rural towns like mine. Their job is to support the families and take care of the patient, making him/her comfortable. As a hospice employee told me on July 4, "We are here to serve our patients and their families 24/7." What more could we ask for?
Mother's doctor told me he placed Mother on Hospice because he realized I was doing everything alone and it was to help me,but after she died 3 and a half years later,he admitted that he really thought Mother had 6 months or less to live.
Hospice did help me though.They brought supplies,ordered her medicine,had it delivered, had the oxygen sent,got her a wheelchair,sent a nurse twice week and a bathaid twice a week,and a Chaplain once a week came too and through a Grant Hospice had,Mother was approved to receive Compassionate Touch where a lady came and rubbed Mom's back and she was even treated to a Frank Sinatra show by her Hospice too.
My Mother lived and slept in her lift chair too like your Dad does too.She said she wanted to be out in the den where the action was.As long as your Dad is comfortable,that's all that matters.
I'm glad you're getting some help now too.Take good care~
Try this instead:
https://innovation.cms.gov/initiatives/Medicare-Care-Choices/
Besides seeming to be what could be a viable modification, I found something of interest: "selected hospice providers" would participate. I'm wondering if this means competitive bidding, or what criteria would be established for the "selected" providers.
On hospice, mthr still lived in memory care, but she had an aide to bathe & dress her and 2x month visits from a nurse practitioner. The real help was in having no more ER visits! Hospice was called instead of 911 and she was treated by dementia spectialists instead of docs bent on over testing her and confususing her further. It was a true blessing.
Palliative care is for people with a chronic disease who have decided not to pursue any more treatment for the disease. In my mother’s case (she was 97), we decided against any more hospitalizations for the CHF. She received comfort care which included antibiotics for pneumonia, skin management, etc, but no aggressive treatment for the CHF itself. An aid came to the AL to help with bathing and she had a volunteer to visit. This would go on indefinately, since CHF can’t be cured. They dealt with equipment needed and management of oxygen. She also had RN visits for assessment. If she got to the point of 6 mos prognosis, she would have been moved into the hospice phase. She passed away in her sleep before this happened.
Hospice is given when there is a 6 mos. prognosis. It is more intense comfort care, more nursing visits, etc. If a person lives past 6mos, hospice can be extended by the dr. If they become better, they may be moved to palliative care.