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    • CommentAuthorbilleld
    • CommentTimeFeb 6th 2010
     
    My DW seems to be going down hill rapidly. She is now in a nursing home and sleeps most of the day, either in bed, in a recliner or in wheelchair. She is sometimes very hard to feed by spoon or fork. Does still suck on straws for liquids. Walking is getting much more difficult and nurses seem to prefer to use her wheelchir for all transitions, even in to the bathroom.

    What criteria does Hospice look for in predicting their 6 month judgement? This Christian Care Center does have Hospice availible. Who requests their analysis?

    Than ks for your comments. bill
  1.  
    billeld, you can call Hospice yourself for an evaluation or call your Doctor for a referal that way. I called Hospice myself and after admitting him they called our Doctor to sign off on his being admitted. It sounds like she would qualify for their services. They will send out a Admitting Nurse to evaluate her. It won't cost you either way.
  2.  
    In our case, Bill, I asked the doctor if he thought Foster might need to be evaluated by Hospice. He said it might be a good idea, and wrote a prescription that read: "Evaluate for Hospice Care". Then I called a Hospice group - they came out and said he was not nearly ready. I called a second group upon the advice of a friend, and when they came out they declared he was, indeed, a candidate for hospice care. Five weeks later, he passed away. While they were on board, their care was greatly appreciated, as he was still at home. Since your wife is in a nursing home, I don't know what they would do, quite frankly. For us, they sent an aid 3 times a week to bathe him, shave and dress him. The aid was here about an hour each time. An RN Case Manager came to the house once a week to examine him, take his vital signs and observe him. Later, in order to provide some respite care for ME, they sent LVN's to the house, 24 hours a day, for six days. (The original 4 was extended 2 days as he was declining) I did not rest, because he became unconscious during the time they were here...and we all stood vigil at his bedside those last days.

    Since the nursing home provides the bathing and dressing assistance, I wonder what the Hospice group would be able to do for her and for you? I am sure others have had LO's in nursing home with hospice care and can tell you about how it works there.

    I'm so sorry she is going down hill so rapidly. It's so hard for us to watch this and not be able to do anything to stop the decline.
    God Bless YOU!
    • CommentAuthorjoyce43*
    • CommentTimeFeb 6th 2010
     
    Bill,
    I'm pretty sure your wife would qualify for hospice. With AD there is no 6 month time frame. My dh was under the care of hospice for one year. At the time he qualified, he was still able to shuffle around, eat and even talk.
    We had an aide 5 days a week plus a volunteer l day a week for 4 hours. They provided all medication related to AD along with pull ups, diapers, hospital bed, wheel chair, hoyer lift and any other equipment I needed during that year.
    During that year he was admitted to a NH for 5 days every month.
    When a hospice patient is in a NH, hospice will still provide all these services. Our volunteer even visited him during the time he was in the NH.
    The extra eyes they provide in the NH gives you some comfort knowing they are watching out for your wife.
  3.  
    Joyce, I am just curious about your husband being admitted to a NH 5 days each month. I haven't heard of that and wondered.
    • CommentAuthorjoyce43*
    • CommentTimeFeb 6th 2010
     
    Vickie,
    Hospice, at least here in Mich., allows a five day respite every 30 days. This gives the caregiver time to recoup. The hospice I dealt with did not have a place of their own to use so they worked with NH's in the area.
    This gave me an opportunity to check out NH's in case I would need to place him at a later date. Never reached that point but those five days gave me the strength to continue careing for him at home.
  4.  
    I think that is wonderful. And, as you say, it gave you the opportunity to check out NH's. You were a great caregiver.
  5.  
    Our support group had a talk yesterday by the Chaplain of the local Hospice. She said that there is a 5 day respite period for the caregiver every 90 days. For this time, the AD patient is admitted to the local hospital. Unfortunately for me, that respite period is about the only thing hospice would do to help me at this point, so she is not yet ready.
  6.  
    MaryH's husband lives at home and he is in Hospice care. Every month she can put him in the Hospice Hospital for 5 days. I was told my husband could also be placed, but he was so sick - they elected to send an LVN 24/7 to our home to take care of him.

    I understand that most hospice groups offer the respite care every month here in Houston.
    • CommentAuthorDianeT*
    • CommentTimeFeb 7th 2010
     
    Hospice told me it wasn't so much 6 months before they came in. Many times they are called in and patients actually get better. They can go on and off of hospice. I know it varies site by site but you might want to check with them.
    • CommentAuthorjoyful*
    • CommentTimeFeb 7th 2010
     
    I called in hospice for my husband but found that I really didn't need them because of the marvelous care our staff at the NH gave him. One item I did appreciate was the air mattress the hospice people put on his bed. It helped to keep away bed sores and was very comfortable for him. They were very kind and eager to do anything they could for us. If he had been home I know I would have benefited from their help.
  7.  
    I am what is know as an 11th hour patient visitor for hospice. It is an honor to be with a patient as he/she passes to a new life. It is a moment of calm and peace. Nothing to fear. We are called in by the nursing staff. Even in the ICU no one can predict when the time will come.
    • CommentAuthordeb42657
    • CommentTimeDec 1st 2011
     
    I am not really sure how they determine the 6 month period but with our case the dr. said he wanted hospice to keep an eye on him and even though he doesn't qualify yet...he still writes perscriptions for them to come and see him so I am thinking that the dr. thinks that anytime now he will qualify and as far as the 6 months goes. I have heard that the dr. is the one who says the 6 months and then hospice qualifies them based on that knowledge but if for some reason they live longer than that they will not stop taking care of them they will just keep reevaluating them and sometimes they will even disqualify them for a period of time even with the 6 month period of time diagnosed.
  8.  
    This is an old thread but my thoughts seem to fit here. At the beginning of the month our AZ support group had a speaker from a hospice and she said anyone could ask for an evaluation. I called them this week and someone came out today. Her first comment was that people wait too long to call.

    She said the weight loss was enough to qualify him. All we need is for his PCP to sign off on it. I didn't really think they would qualify him. The weight loss was 8 lbs from November to May and 7 lbs from May to September (last week). He still looks pretty good at 160 lbs.

    Its just that he can't do ANYTHING for himself. He is totally incontinent and I have to bathe ,shave, dress and wipe his butt. He can shuffle short distances behind the walker but I use the transport chair to go the length of the house to the bedroom.

    So we'll see what happens next week.
  9.  
    Mary-I see by your profile that you have been a caregiver for a very long time. Hospice is to help both of you-not hasten a death. They can give the break you so badly need. I volunteer with hospice to sit with patients so the spouse can get a break. Sometimes it is to play cards with a group of friends. Sometimes just to wander through a grocery store without worrying about what is going on at home.
    • CommentAuthorAliM
    • CommentTimeSep 20th 2013
     
    Mary, After my DH was admitted from an ALF to a 14 day hospital stay for dehydration he was discharged to hospice. The two things he is capable of doing are feeding himself and walking in a merry walker. Since he wanted to get up and walk he was drugged in to oblivion with haldol. He lost 14 lbs because he was not conscious enough to eat or drink. Two hospice doctors and three Alzheimers specialists told us he needed to go to a hospice facility and that it would not be long before he passed. My DS and I stood at the foot of his bed and planned his funeral. After three days in hospice and the drugs wore off they started feeding him and on the fourth day they got him up and let him walk. After eleven days he was discharged from the inpatient hospice facility to a NH at an additional cost of fourteen hundred dollars a month above the previous ALF costs that I pay. We gave up his bed at the ALF and could not find another suitable ALF. After eight months under hospice care at the NH he was discharged back to his PCP. He has since gained back 12 lbs and continues to walk in his merry walker and feed himself. This was one year ago. This is also the time I lost all faith with the medical professionals dealing with dementia. They are clueless. Sorry, but that is how I feel. I will say that during the eight months the hospice nurse, social worker and the visiting volunteers rendered wonderful care. My suggestion would be go for the hospice evaluation and accept if he qualifies. Any small amount of help you can receive with his care will be a good thing for you. Take care.
  10.  
    I got a call from Hospice this morning that said the PCP had signed off for hospice and two nurses were were here this afternoon to set everything up. They will have someone here 5 mornings a week to get him up and into the shower and dress and shave him. They will even start the laundry if I want it. ( The bed is soaked every day.)

    They will also provide his pull-ups. Could have had a transport chair, but I bought one a few weeks ago. I decided not to go with the hospital bed after reading here on the boards that if they discharge him, they will take it away. I think I would miss it more if I lose it than I would never having it. They said if I change my mind I can call and they will have it here the same day. We'll see how it goes. They will reevaluate in 90 days.
    • CommentAuthorAliM
    • CommentTimeSep 24th 2013
     
    Mary, That is great news to hear. I know that having assistance five mornings a week to shower, dress and shave him will give you a little bit of relief. Before placement that was always a struggle for me. I hope you can have a little time for a relaxing cup of coffee or tea. This time will also give hospice workers first hand knowledge for future evulation. I hope this goes smoothly for you.
  11.  
    An aide was here at 7:30am to do the Shower and all. I was there this time to tell her what I do so it wouldn't be too different for him. I wasn't sure how he would react to a stranger in his private space, but there was no reaction at all. Boy, my back is going to be very happy with this help. It will be a different person tomorrow as this one has a class tomorrow. Beth will be back on Friday. Hope it continues to go well!
  12.  
    When we got home health care, Claude totally refused an aide (woman) to see him "nekked" so I had to continue to bathe him. He went on Hospice four years later and it didn't bother him by that time. Malinda was great with him and he liked her, so there was no problem. Having her there 3 days and later 5 days a week really helped me. I don't think my back would have held up.