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It is likely time for me to consider hospice to help with the complications of home care and to keep from having to call 911 when things get to be more than I can handle. My mother is very up and down with being ok and then being on the brink of a hospital trip. What if I need a facility in the near future? Will being on hospice make it harder to get accepted? She really does not have any major illness, just old and up and down with dehydration and UTIs. She is 96 and would be private pay with LTC insurance and her own $. We are fortunate with that part. I am not sure that I (and my husband) can handle all her needs if they get more difficult.

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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.
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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.
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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.
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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.
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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?
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iameli May 2023
I’m guessing it won’t matter to the facility especially if she is paying the bill. You should know that hospice won’t provide much help for you at home, with the amount of care you are describing. They will bathe her twice a week; the rest will be up to you.
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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.
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AnnReid May 2023
I think that may vary, perhaps from state to state?

My LO was a hospice patient in a memory care setting for about 6 months, then was moved into LTC where she lived almost a year.

So she was in hospice care for about 17 months.
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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!
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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 ....
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jemfleming: No, being on hospice should not have a bearing on placement in long term care.
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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.
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