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My mother has broken her 2 hips, ribs, back, and wrist in the last6 months and is nolonger eating much. She is 89 years old with severe osteoporosis and currently in a wheel chair. She has little strength for rehabilitation but continues to want to use a walker again which is pretty unrealistic considering her state of failure to thrive. The social worker said it is time for hospice but my mother wants to continue rehab to be able to walk with a walker. She is too frail to do this. She is afraid of death and I think if she was told she was going into hospice , she would loose her will to live.

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In the legal sense, is your mother able to act in her own behalf and make decisions? Does she have a healthcare directive?
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She has a living will and wants no extraordinary measures to keep her alive. She is doing poorly in therapy as it has been painful due to her numerous fractures and broken wrist. When asked , she wants to continue therapy inorder to walk with a walker although her chances of accomplishing that are very poor as she eats very little and is continally losing weight. She has gone from 105lbs. to 80 lbs, in the last 6 months as she has no appetite. She is also extremely weak , unable to stand by herself and in pain. She is on tramadol every six hours and refuses anything stronger. She sleeps much of the day and has very poor circulation. However, she is very stubborn and is not about to admit that she is dying. Again, I'm afraid that if she goes on hospice she will give up as she will think there is no hope for recovery. PLEASE HELP ME UNDERSTAND HOW TO TALK TO HER ABOUT GOING ON HOSPICE WIHOUT UPSETTING HER.
Thank you!!!!
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If she goes on hospice that will pretty much mean that there is no hope for recovery. In fact, from the sounds of it, if she doesn't go on hospice there is no hope for recovery.

From the sounds of it, she is dying. If you don't think she would want to have to acknowledge this, I'm not sure it is necessary/helpful to insist that she face it. Instead of saying "there is no use in continuing PT; it is hopeless" I think that I might say, "We need to give your bones a rest to heal before we work on the walker any more." Is there any other treatment your mother would have to give up to receive Hospice Care?
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Having a fear of death and wanting to keep living is a natural thing. When therapy fails to remedy, and at 89 that's a distinct probability then its time to make the most of life. Instead of denying the ultimate end we all face, hospice gives people the opportunity to die naturally, to prepare and do things that need to be done. Its a time to enjoy what life we have instead of trying to deal with frustrating medical interventions. Taking the last period of life and immersing yourself in life, enjoying it to the fullest, instead of using that time for unnecessary medical procedures makes sense. Hospice does not mean giving up, it means a chance to use the last period of life to best advantage for the patient and includes appropriate medical care augmented with spiritual and social care for patient and family.
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Thank you sooo much!!!!
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This describes my mother and my situation starting last year. My mother loved life and intended to "stick around". A lot of how you approach the topic depends on your mother's mental state. My mother could no longer leave the apartment for any care, not yet bedridden but severe back and hip pain. Also unable to stand and barely walk without assistance. When her Dr told me it was time for Hospice I explained too mother that it was a service the Dr was prescribing for her to receive weekly nurse visits at home to make life easier for ALL of us. Even with some doubts and dementia she understood this concept. We did not use the word Hospice, but when necessary referred to it as Club H. The nurses even removed their ID badges (their idea)! None of this was a lie, we just put a different slant on things. The Hospice people are soooo nice and caring and spent real quality time with her. She loved the attention and additional weekly company. Also your mom may accept some "direction" from them that she won't from you, even if it is the very same advice. It all worked out wonderfully for us and my mom got the best care, she even thrived and gained a few pounds and I got the help I needed too. She passed away a few weeks ago, at home, in her bed with us around her. She was 2 months shy of 99!
Good Luck.
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Excellent advice all around. My parents benefited so much from hospice. They were able to live their lives without pain and with dignity - until it was time to die. You local hospice will have a chaplain who can help you along with the steps. Once your mother accepts she will die either way, she'll realize it's better to live in a way where she can enjoy her family. Take care, my friend. This is hard, but hospice will help the family, as well.
Carol
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Dear Freddie, There is often a sigma placed on the use of the word "Hospice." Even among the medical community I found even some physicians don't understand their services. Another word which better describes the services they render is "Palliative" care - controlling a person's pain which allows them enjoy life a bit more. I had Hospice with both my husband and my mother and they were wonderful just as kdaniels47 describes. My advice would be to call a hospice care service near you and set up an appointment to talk to someone; they will be able to guide you on how to approach this situation with your mom. Good luck and keep us posted!
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My mother was buried one week ago today..we only go to use Hospice for four days. In those four days the Hospice staff were just wonderful and helpful with my mother..I believe once your mother sees just how wonderful Hospice really is she will be happy they were there for her (( :
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svalle, sending love and light to you all. My Dad was receiving weekly hospice visits but he is in the no eating and drinking phase of things, and hospice is here daily. It's a great gift for all of us.
My Dad, too, was against it. But when he "gave it two weeks" as a trial, he ended up liking that they came to him, that there wasn't the strain of getting into the car, etc. And he liked that it helped US deal with the strain of things. SO, Freddie, maybe ask your Mom if she'd do a two week trial. Also, the hospice people can explain that their services can go on for years, if need be, and that they have, for some people.

Good luck
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It doesn't matter whether you "go gently into that good night" or go kicking and screaming. What matters is that you are comfortable as possible and feel loved and supported. I agree with some of the other posters. Bring in hospice, even if you have to fib about it. Your mom is just expressing fear of the unknown. Once she gets some care and starts feeling better, she will likely change her opinion. As for the PT, I can't believe that whomever is providing it hasn't put their foot down. Says a lot about why health care is in the state it's in! Whether or not PT is indicated shouldn't be a patient decision.
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Hospice can be in home care.
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Reading what you, your mother and your family are going through right now is extremely difficult. My mother died just a few weeks ago. She had a terrible fear of dying!!! I had been taking care of her at my home and she just kept getting weaker. I couldn’t physical keep taking care of her without medical equipment hospice was able to supply. I had called hospice and talked with them before having them meet with my mother. Then they came and talked with her just to inform her of her options. That was very helpful. After she agreed and we got the hospital bed, bedside commode, wheelchair among other things it made her life more comfortable and mine. She was actually able to move around more! We had hospice only for a few week before my mom passed. We had no idea it was going to be that soon. Let hospice talk with her give her options and like I saw someone else mention use it as a trail she can always stop it if she wants. My prayers are with you.
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I would not tell her the people coming are hospice, no no no! I will never tell my mom that either. I will just say they are extra nurses to help us. They are nurses, you just leave the hospice part out.
she is likely from the old school that hospice means immendient death...its too complicated to explain to an 89 year old. let her do what she wants to do with her walker and all other things as long as she is not in harms way...that is her will to live and recover! That is my take, good luck to you both.
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Perhaps if you explain to her that hospice is not only for the dying-that if people get better they can be "fired" from hospice. For my mother, the big benefit of hospice is the freedom from financial worry- they pick up a number of the costs associated with her disease. While hospice ic certainly there for the end of life, they help make the rest of life as good and painfree and worry free as possible
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We all need a reason to get out of bed. Being able to walk with the walker is a goal she has, and while it may be unrealistic to you, to her it is a reason to try each day. Every person has goals in life, and while we may not realize them as such, it is what keeps us motivated every day. Never take away anyone's dreams. On my brother's death bed, he still talked about wanting to go fishing, and finding a girlfriend.

I absolutely agree with putting a spin on things that she is not willing to deal with. It makes her more comfortable, and right now, it really is all about her. While she is awake, encourage her to talk about happy times, childhood friends, vacations, christmas'. Most folks feel comfortable talking about the past, instead of the future. The Hopice folks will find a way to become part of her life, and make your's just a little easier. Hugs!
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Telling your mother that she is going on hospice would be like telling a child who is afraid of the boogy man that the boogy man is coming over tonight but he'll be nice!
Your mom knows darn well what hospice is for; its for the living who are coping with dying.....oh please. Do not scare your mom and for what purpose?
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And even when our LO is not aware of his/her surroundings it is said that they can still hear everything.
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Thank you soooo much for all of your comments and help. At this point my Mother seems to be improving but all this informatioin is so very helpful!!!! It will certainly be welcome when my mother needs it which could be at anytime.
My very best wishes to you all and I will save all of these incredibly helpful answers.
Love and light,
Freddie
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My Dad always said he was not afraid to die but her was afraid of what might have to happen first, or the actual process... This may be what is bothering your Mom. We were able to keep Dad comfortable and he was able to die peacefully with dignity in his own bed. We had hospice for medications and equipment, they were wondertul!!! I would encourage you to respect her feelings however know that you may have to just help her accept the inevitable... Hospice has social workers and a chaplain they can be wonderful resources for you and for your MOM. take care!!!
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Thank you so very much for your helpful answer.
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Hospice or palliative care is the best medical "discovery" since life began. It is all about easing the pain-actual and emotional -of loved ones leaving us and our missing them. Not everyone has the good fortune to get this care early; many wait too long to admit that death is part, the final part, of life. Hospice allows us, all of us, manage it with dignity and fortitude. Wonderful people, wonderful care.
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I agree hospice was WONDERFUL for my Father. My son and I (we are nurses)did his actual care however they helped with equipment and medications. They were extremely supportive and caring!!!
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Thank you so much for your very encouraging post.
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Freddie, I am so sorry to read about all of your mom's broken bones, weight loss, and fragility. I cannot imagine the physical pain she has endured and is experiencing. How sad she must be. You are a terrific child to her. The other respondents have done a wonderful job with advice on how to broach the topic of Hospice care with your mom; I am going to write a bit about the other big strain on your mom's mind - her pending passing. I don't like to assume things, but is your mom not too spiritual or religious? I used to have the same fear as your mom until I started to do a lot of reading about people having momentarily died, experiencing the peaceful after-life, and then returning to life after being resuscitated. Also, there is a t.v. show called 'I survived beyond and back." If you can find that program or get copies of past shows, you will watch doctors and nurses and emergency personnel verify that those people really did die on the operating table or in an accident and were then revived. The after-life experience of almost every single person on that program is very similar: a warm, loving, peaceful feeling - seeing a God-like or feeling a God-like presence, seeing past loved ones and friends, etc. ... . Even if your mom is not a current believer, just watching all those people speak of the joy, peace, and happiness they felt in the after-life is bound to make her feel better than to just live in abject fear of passing. Even if she doesn't believe it after watching the show several times with many testimonials, it's still good for her to see something so nice and uplifting. No one really knows the truth, obviously - but isn't it better for her to feel hopeful that it may be real, based on so much testimony, than to be so sad and depressed while in Hospice? Good luck to you and your mom, and again, please know how sorry I am to hear about her pain and poor physical health. Best of luck to you all.
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Thank you so very much for the great idea of trying to get copies of those life after death show. Great idea!!!! You are so very thoughtful to help me with this situation with mother.
Blessings and Peace to you.
Freddie
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Why are you trying to prematurely kill your mother off? A hospice is a place where you go to die. Your mother does not have a disease that is killing her. Of course she is not eating much- she is in pain and fear. She has poor circulation because she is not getting any exercise. She is sleeping because she is drugged. Naturally that is making her weak. She is injured, not dying, though it sounds like the family would gladly bump her off if possible and that is what you would do if you shoved her off in a place where people go to die.

My grandparents lived to 100 and my mom to nearly so. She had a bad injury too and the same sort of results. I found a medical program where she would receive some nourishment by tube while having physical therapists "exercise" her in bed. Her circulation improved immensely and she gained weight. Many older ladies don't weigh a lot anyway. None of this is extraordinary measures- just what you would do for anyone with such injuries. The injuries here are the key to the problem. She wants to continue the therapy and it is HER life, not yours. Why do you want to throw her away and break her spirit? She CHOOSES to 'LIVE. Your mother is not dying. That is just wishful thinking. She is trying to work though severe injuries which cause suffering and she is working on her rehab. You are the one who wants to stop it and for that you should be ashamed. By the way, my mother recovered with PROPER care (and I wanted her to) and went on to live many more years with her walker.
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I liked kdaniels47 idea...and sort of practiced that approach with my mother, though not about hospice. To your mom couldn't the hospice people be "new friends" or "just visiting" or evaluating her for physical therapy or something like that. I understand wanting to protect her mental well being. I wouldn't want to take the chance of dashing that either. I wouldn't associate the word "hospice" with the visitors.
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You are not going to change your mother's deep beliefs about hospice with videos; it is what it is.
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Just for your information, terrimerritts (although there is really no evidience that you want information to get in the way of your insulting remarks), hospice is NOT a place where you go to die. It is not a place at all. It is a kind of service that may be provided in a care facility, in a private home, or (in some locations) in a facility dedicated to providing the service.

Seeking hospice care is not about trying to kill someone. When my granddaughter arranged hospice care for her father in his home, she was trying to make the time he had left less painful and more dignified for him. She was not "wishful thinking" about his death.

You are certainly entitled to your opinion that physical therapy should be continued. I can respect that opinion without agreeing with it. What I cannot respect is your judgmental attitude and language. This is a site for mutual help. Accusing someone of trying to kill off their mother is hardly helpful, in my opinion.
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