She has heart problems and PD. Is now in AL. Has fallen often, but only gets x-ray if she hits her head. The RN reviews her meds, and reports changes, but she doesn't get to Dr's office or dentist??No pain, but I feel no one cares because "she is a hospice patient, so do nothing. Am I wrong? She is 87 and somewhat confused to time and day.
Routine Home Care
This is the most common level of hospice care. Routine home care includes, but is not limited to, nursing and home health aide services. Patients may receive Routine Hospice Care in their home or what they “call home”—in a long-term care, assisted living, or free standing hospice facility.
Continuous Home Care
Continuous Home Care is provided during periods of crisis in which a patient requires continuous nursing care to achieve palliation or management of acute medical symptoms. This intensive care is provided in the patient’s home or facility where they live. In addition to being visited by the team members, the patient will receive up to 24 hours a day care by a licensed nurse and hospice aide, when on Continuous Home Care.
General Inpatient Care
General Inpatient Care is care for pain control and symptom management that cannot effectively be provided in other settings. It is usually of a short-term nature and can be provided in a hospital, hospice unit or long-term care facility. Compassionate Care Hospice has dedicated inpatient hospice units in some of our programs.
Respite Care
Respite Care is short-term inpatient care provided to the patient when necessary for the purpose of providing a break in caregiving to the patient’s caregiver(s). It is only provided on an occasional basis, for a maximum of five days approximately every 90 days. Respite Care is provided in a hospital, hospice unit or long-term care facility.
Please see my prior posts (2) for more information
My mom is in a nursing home, terminal Alzhheimers, slow decline, I have no idea what I should be asking.
You need to provide more information. A 72 yo alcoholic who can....still care for themselves? Lives alone? Has no real health problems besides the alcoholism? You can't just snatch somebody and place them in Hospice care, they have to pass some pre-testing. Being an alcoholic, placed into Hospice? if they are still actively drinking? Probably not, because Hospice is pain meds and end of life care--that isn't going to work with a load of booze on board.
Smikulick--I am sorry for what you are going through. Yes, having a loved one in Hospice care at home does make for a lot of work for the caregiver. I am sorry yet grateful that when we placed daddy in hospice, he no longer could get out of bed or walk at all. I can't imagine if he had tried to do so, he was a big man and I personally would have had to call paramedics to help me.
As far as the hospice nurses not catching the UTI--well, I don't know. Ours did a stellar job with daddy, testing his blood and urine each time they came. UTI's are common in patients with catheters. Also, the blood tests would reveal any infections, etc. Maybe Hospice isn't the best course for you if mother is still ambulatory? Or maybe you need to move her to more intensive care. These problems you mention aren't the fault of anyone..it's the situation, which is very sad. Your mom wants to walk. She's in pain and not aware of her surroundings. This can go on for a long time. Maybe you need to re-evaluate having mom with you? Just a thought. Sounds like more care is needed than you can give.
So sorry to hear about your mother. Alzheimer’s is such a challenge, it’s good you are thinking of planning ahead. It is quite likely that she will eventually be just bed bound and sleeping more and more until one day she doesn’t awake. In which case you may need nothing more.
Important question number one. Did your mom, while of sound mind, create Advanced Directives giving guidance as to what she would prefer? If not, did she ever talk about whether or not she would want heroic measures *even* if she were terminal? If she did not, you are faced with the task of deciding what she may have wanted and what you feel is appropriate. Tough question number two: how do you want life to end?
The decision point here would come if her Alzheimer’s takes the course where she eventually stops eating, or eats so little she is wasting, or can no longer drink water. At that point the body has run its course and is beginning to enter the dying phase. Many people, facilities, and religions are uncomfortable with this and want to institute tube feeding and forced hydration at this point, regardless of the state of the patient’s consciousness. The tough question here is quality of life. Would she want to have lived like this? If not, it is time for a hospice consult.
What hospice will do is give her medications to keep her comfortable and allow the body to take its course. Usually death is no more than a few days to a few weeks off (if the assessment is correct). At the very end some will argue that it is cruel to “withhold” water, however, to inject fluids when the body is no longer capable of pumping them out is essentially forcing the person to drown. An MD or experienced hospice RN should assess to see if this is indeed where the patient is at.
I hope this gives you some starting points. Peace to you and your mom.