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You don't need to put her on Hospice if you don't feel it's right at this time and you both want her to continue to receive medical treatments. When you are ready for Hospice, I suggest you interview a few Hospice organizations to find one that will be the best fit for you both.
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Kathycan313 May 2019
Thanks so much for your comment. Until I posted on here I didn’t realize there were options in hospice companies. We are going to talk to her and see if she understands enough to make the decision herself. I’m also planning on a meeting with hospice to discuss our concerns.
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The answer is not the same for everyone.

A few months ago, my mother's confusion seemed to get worse, and she seemed very dizzy so we took her to her PCP. They recommended checking for a UTI due to the dizziness, but set us up with a hospice consult.

In my mother's situation, withdrawing renal dialysis would end her life quite suddenly. They said they could not stop treating the heart condition without also stopping the dialysis. They could try to get her qualified with the COPD, but in that case, she could no longer be treated for anything respiratory. Not even antibiotics to treat bronchitis to prevent pneumonia. So they CAN qualify and stop treating just one condition, and you have the choice about what that is and what it looks like.

You can also decline their services for the time being.

We asked for some time to think about it, and the hospice office called TWICE A DAY until I told them to stop calling, that I felt they were pressuring us into something we were not ready for.

Mom's confusion went away with her UTI antibiotics, and she has proceeded to get stronger every since.

When the time comes, we will welcome their services. But it will have to be when we are ready, and she is able to give her consent.
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NeedHelpWithMom May 2019
Wow, gets confusing doesn’t it? I think you did the right thing by following your heart and logical thinking. If you aren’t comfortable with the advice that was given then I feel like you made the right decision.
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How you and your mother might feel about this perhaps depends on her level of ‘declining health, weakness and confusion’. My brother-in-law was in the final couple of months of cancer when he fell and broke his leg, earlier this year. He too was treated for pain but the bone was not set. The reason was that the break was not likely to heal before his death, that setting would not make him mobile to get out of bed, and that the cast would make bed treatment more difficult. He was furious to have broken his leg and would much have preferred to continue to be able to get out of bed, but on balance this was the best option. Pneumonia, your other example, used to be called ‘the old man’s friend’ because it was a relatively quick and kind death. My first mother-in-law actually wanted this rather than going to a nursing home – she had had pneumonia in her early 90s after a walk on the beach when she got too cold, and said that if she was fading she would like it to happen again and not call the doctor. I have been sorry for years that it didn’t work out that way, and she lived till three months short of 100 unable to talk, feed or toilet herself, exactly what she didn’t want.

For me, your examples are not close to ‘assisted suicide or even murder’, and I don’t think that basic medical care always means keeping people alive. We are all going to die, and prolonging life without quality is not what most people would choose. The Bible doesn’t deal with this, but then when it was written there were no options and death was ‘God’s will’. It still is. Your mother is only 83, and perhaps the issue is whether you and she feel that she will have happy years left to live if her medical problems receive the maximum possible treatment. Best wishes at a very difficult time.
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NeedHelpWithMom May 2019
Thanks for sharing this experience with us. Helps to understand how to evaluate the situation. Can be confusing and difficult to decide what is best.
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I'm not sure how different Hospice programs vary, but, I never heard anything like what you describe. Granted, regular blood testing may not be conducted, but, falls are a different matter. Some medications are discontinued, but, not those that relate to comfort and so my LO takes antibiotics if she gets a UTI. As far as a fall, fracture and surgery, it would depend on the circumstances and if surgery was deemed necessary. Some patients are not strong enough to undergo surgery nor able to recover, even if they did survive.

I think you can stop Hospice at any time, if you wish.

My LO is on regular Hospice and I feel quite comfortable with their policy,
mainly due to the fact that my LO was very clear in her wishes for how she wanted things to be done, under these circumstances. Her mother had a similar experience and I was with them both as they made decisions. She made me promise that I would make sure that's how she wanted things to be. So, when someone is ill and cannot recover, not to continue with measures to lengthen their days. But, to keep her as comfortable and pain free as possible.

Of course, it's a personal decision. Does your mother have an Advanced Medical Directive or has she told you what she would want?

Also, it's my understanding that Medicare pays or all Hospice care expenses.
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Kathycan313 May 2019
Thank you so much for sharing your experience. I wish mom would talk to us but for years anytime we e tried to find out what she wants she would just shut down.
We will talk to her soon and see if she understands enough to make a decision on her care. Blessings to you and your family.
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So, it sounds to me as though you are confident that your mother would still want medical treatment for what ails her.

If you are confident that your mother is not ready to stop fighting, then I would turn down hospice. You are under no obligation to accept hospice services.

Has anyone talked about palliative care? My mom, similarly, was in a NH with moderate dementia, CHF. My brother, who was her POA, was not ready to sign on to hospice when mom first became eligible, again, similarly, after a bout of pneumonia that sent her to the hospital, which in turn increased her confusion.

We discussed with the NH the fact that we no longer wanted her sent to the hospital for treatment. They treated several bouts of pneumonia and a couple of UTI's "in house". Eventually, she fell and HAD to be sent for xrays; her wrist was broken and set; she declined quickly and we accepted Hospice services at that point. It became clear that mom had no fight left in her, she wasn't going to get out of bed and developed pneumonia.
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NeedHelpWithMom May 2019
I feel it’s best if we respect our loved ones desires. You were wise to see that she didn’t have any fight left and opted not to make decisions for her. Your mom was blessed to have you.

Her picture that you had posted when I first started this forum made me smile. It was a lovely photo of her.
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