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My husband is in a gray area and we don't have unlimited funds. We currently have Home Health Care but that is limited. He is totally JPEG tube fed, food, water and meds. He cannot swallow. He is becoming less and less able to do much every day. I need some help...we are both 78. I have been taking care of him for almost 2 years. He had tongue and throat cancer, which is now gone, last year and underwent both chemo and radiation.

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wndio i don't think you will have any trouble getting approval from your HMO for palliative or hospice for that matter because it can save them tons of money. Fewer Dr especially specialist visits less expensive testing and most of a least days in the hospital. You can still do all those things but when you have regular visits from RNs it is more reassuring to make the decision not to exhaust your loved one by continuing those frustrating outpatient visits. Things like the tube feeding will continue as planned although hospice it self discourages them it has been my experience that if the patients already receiving them they will allow them to continue as long as the patient is not at the stage where artificial nutrition is causing too much strain on the body.
The main thing to remember is that treatment decisions are always finally yours and the question is will this actually be beneficial if the treatment needed will badly affect the patient's quality of life or the patient can not tolerate more treatment even if it is available. for example if your husbands PSI becomes high are you going to put him through a biopsy procedure to confirm cancer when prostate surgery will shorten his life further. Now an appendicitis is another matter, certainly have the CT scan, not invasive and only takes a few minutes and agree to the surgery because otherwise he will die a horrible painful death. Always, always carefully weigh the risks versus benefits with any medical decision for an elderly loved one.
In your case palliative care will be a positive experience for both you and your husband and if you don't like it you can always discharge him.
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www.agingcare.com/articles/Palliative-Care-What-Is-It-and-How-Is-It-Different-from-Hospice-197744.htm
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Palliative care (pronounced pal-lee-uh-tiv) is specialized medical care for people with serious illness. This type of care is focused on providing relief from the symptoms and stress of a serious illness. The goal is to improve quality of life for both the patient and the family.
Palliative care is provided by a specially-trained team of doctors, nurses and other specialists who work together with a patient’s other doctors to provide an extra layer of support. It is appropriate at any age and at any stage in a serious illness, and it can be provided along with curative treatment.
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Thank you, cwillie. This is a very good explanation. I will look into it with my HMO.
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