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Jeanniegibs - Mom is unsure of what she wants. Last week, she said to all of us on a conference call: "I don't want to be here anymore, but if I am here I don't want to just lie in bed and not try". She is very conflicted.

My sister has medical PofA, and she is leading Mom down the path towards Hospice - before Mom is ready herself. You know how someone can influence an elder person? My sister is doing that, saying she is honoring Mom's wishes. All of us sibs interpret her wishes differently - that is the problem. Mom has a bit of short term memory problem (probably from the painkillers) - but no dementia. I don't want Mom to give up on walking and doing PT until she is ready to give up. She is not ready, too wishy-washy right now. Obviously no PT under Hospice - so think there should be no Hospice talk for now. Family disagreements abound, and the sister with the medical PofA likes and takes advantage the "P" part.

I am glad you got such wonderful help - I do believe in Hospice in general. And, I am very sorry for your loss.
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I can totally understand both sides of this coin. I will not say too much on this how I feel about it. I have had family members and friends that had great hospice people and the thing I am noticing is the total confusion with medications between the doctors and the regular doctors. I know they are great helpers if you get a great team, but when you have so many different people coming in the home and upsetting to your relative it is very hard to bare witness too. I am between a rock and a hard spot right now with it all. My father says everytime they come here they make his heartrate go up. Some of the things that have been said to him and to myself is so out of the ordinary and unbelievable. Just like anything in this world you got the great and the not so great. My final request to everyone around him is to have dignity and respect for my father as he has had a hard time dealing with leaving us as he has fought all his life to be well. When they constantly upset him then I had to say something. I stay in the room now when they come and I try to be open minded but not everyone has the same experience with the medical professional and I have utmost respect for all of them but some things are just unreal. I am not at all bad mouthing Hospice at all but you must speak up about what is bothering you so you can get the proper care for your loved one. I too was concerned about the heavy medications as my father has had some serious falls here and it concerns me very much now that he is getting weaker and not eating the meds are very strong. I wish there was an easy answer to all of this but there is not. We do the best we can. They do the best they can. It is hard for family members like myself to watch this going on. I have been on overdrive with everything and my body is worn out but when my father can not fight anymore I assured him I will be standing up for him and will continue his fight. These end of life issues are the hardest on the entire family and even harder on the patient. I just ask that anyone that comes to see my father while he is still in my home with my son and I, that they have the utmost respect for him. I am his daughter and have tended to him for two years and this is the hardest thing to watch unfold day by day. I do like our aide and the chaplain and we have had so many different nurses - each with a different views and opinions and being under duress with exhaustion leaves me not able to sleep very well. It is so conflicting all this with so many different doctors and nurses telling me so many different things all the time. Here is major confusion for me and I can only wonder the upset and confusion it is causing my very ill father. It is a hard call to make. Just talk with the leader of the team and express your concerns and see if you can come to some peace with it all. It is hard but they are there to help and we are there to watch it all so we need help as well. I will keep you in my thoughts and prayers. We need the professionals and hopefully you get some great helpers. Blessings!
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Crystal1224...I'm sorry to hear that you and your father are receiving a mismanagement in care. I can totally understand why you would feel a little frustrated.
When mom was in the middle of her night walks..up and down all night long. I was at my wits end. That's where hospice did everything for me to help mom sleep. Although after many trials of meds. I made it my own authority to take mom off of the drugs hospice prescribed and gave her only over that counter medications. I don't know what kinds of drugs your dad is on right now. But I do know with mom, if it didn't work or made it more difficult for her...I would immediately stop it. I had the control over what was given. I monitored her and distributed the medication and if it made her too groggy. I stopped it. I also went on my computer and learned as much about the disease and the medication that I could so that I knew what it did and how it affected mom. All of my hospice gals were very respectful and considerate. And if I had any issues at all I would call the nurse or the social worker and they would resolve it for me. I'm so grateful for all of them... I could not have done it with out them. I hope for the same for anyone who is offered Hospice. Because I believe they are angels sent from above. God Bless.
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So your main concern, Angie, is whether Mother continues with physical therapy or not? Is that what you mean by "suicide" -- continuing with physical therapy?

I wonder if your sister would be willing to hold off on hospice while Mother tries a round of PT? Ultimately this will be your sister's decision, since your mother gave her to power to decide.
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Did the doctor recommend your Mom receive PT? With failure to thrive, PT would seem to be extreme and tiresome for your Mom, probably doing more harm than good. My Mother would have a good day of PT and then 3 days of recovery.

Some patients go on Hospice and come off several times during this final stage of life. The family can even make that determination themselves.

I know this is very painful and stressful for your family. Please enjoy the time you have left with your Mother and not spend it being hurtful to each other.
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Since Mom would not be getting Hospice at home (she has an assisted living apartment on self-pay, but she has been at a rehab facility for a month, Medicare-paid) if would be much more difficult to have her go on and off Hospice (Medical paid if necessary). She does not want to give up her apartment 'just in case'. We cannot afford round the clock care in her apartment, and they will not allow you to live there if you need hospice anyway. You have to be independent.

Mom does want PT, wants to try, but hates it at the same time - very conflicted. Dr does recommend it, Psych Dr said last night he could tell she was depressed but not ready to give up. She is on antidepresants.

Jeanne - not sure I understand what you mean by PT and suicide relating. Mom IS making progress walking in PT - but no one can tell if she will be able to get in and out of bed and wheelchair herself (that is all Mom wants).

I am not OK with sister having the "power" even if it is legally true. It should be a collective family decision to interpret Mom's wishes.
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I so agree with Angie on it should be a family collective decision on parents care, etc. I do not have POA but I have been sole caretaker for two years now and I talk with my family members and they are too distraught to talk about those hard conversations so it leaves me to do it and I do. I hope the family can gather around and talk about what is most important for your mother and not be one sided in the conversation. Blessings to you Angie.
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I forgot thank you Ms Daisy for your comments. I am trying to do all the right things but at times don't know what if right at the time. Long as I keep Dad comfortable that is my main thing and I always ask him if he has pain. I have seen a great decline in the past few days and I am scared. With my faith and all I am still scared. I know I have to let him go and when that happens I pray for the peace to all in our family. I need to talk to the nurse today when they come and see what they say. I am having a difficult time now dealing with it and at some moments I am strong but more so I am lost. It is hard to express these feelings correctly I only know I can write how I feel at this very moment. I will try to come back on later today. Blessings and a gift of gratitude to all of you on this site. Just coming in here makes me feel like this is all my family too. What a great bunch of loving people here. God Bless you all.
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Physical Therapy can sometimes be provided under hospice if there are realistic goals that will help the person function better or feel better, or prevent painful contracutres or deformities. If it is just doing a passive range of motion, families and nurses are expected to do that though. Angie, your mom has a simple goal and it seems reasonable to work on as long as it's potentially acheivable, and its not wrong to have hope even for a small thing. You do have to beware of therapists who might be in it just until the funding runs out reagrdless of whether they actually acheive anything or not, but hopefully that's not the case...
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((((hugs)))) Crystal
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As far as it being financially covered - either you are dying (hospice appropriate) or you can get better (PT appropriate). Medicare won't pay for both. Yes, we could private pay for PT while Mom is under Hospice, and I imagine we would try to get that done if she does go under Hospice.

All of you on here are fantastic. And everyone having a different a range of experiences, different stages of the process that have been experienced, is
invaluable. Thanks and hugs to all!
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I think you're right on about assisted suicide= palliative/hospice. My father was basically starved and drugged with morphine/dilaudin over 3 weeks in hospital. The last week was in hospice where they gave more and more dilaudin. I don't know why they tell you the lie that morphine makes it easier to breathe. Morphine depresses breathing, look up the side effects of even codeine, morphine's weakest form and it says to use it with caution in individuals with breathing problems. Years ago it was advised not to use morphine when someone had respiratory problems! My father was admitted to hospital with pneumonia, then during a "swallowing test" he aspirated. Then he was given a ct scan which indicated a mass in his throat, which the Drs immediately proclaimed was incurable cancer. (He was Never given a biopsy, which is the ONLY way to confirm a mass is malignant, it could have been benign or any number of other conditions) Because of this he wasn't given a feeding tube, even though he recovered in about a week from the pneumonia. By this time he was very weak from fighting off the pneumonia and only being given saline, antibiotics, and dilaudin/morphine. We waited for the biopsy that never came (I later found out the Dr had canceled it a day after the ct scan) They wouldn't put a feeding tube into his femoral artery, which they could have done. They said he was in pain, but he told me he wasn't many times and he had no cognitive problems. They kept telling us to move him to the palliative unit and after 2 weeks we did. He was only conscious for about a day out of his final 7 days there because of all the morphine, he was never given a biopsy, or feeding tube. In palliative it was only morphine and a saline iv.
This sounds a lot like "assisted death", even though he wanted to live. Just about a month before all this he still drove, took long brisk walks, etc. I think Drs and palliative are just writing our elders off. When I met with his Dr a month or so after his death, she said " he would've only gotten sick again" when I asked a few questions about his treatment. Guess we should all do away with ourselves because we might get sick. What's sick is not feeding someone for 3 weeks and then finishing the job with morphine. I don't know why I believed they knew best at the time.
Sorry this was so long. Yes, I believe hospice/palliative care is definitely assisted suicide in many cases, and in many cases it's something even worse. And people who tell you that starvation isn't painful haven't experienced it themselves, so there's no way they can know this for sure. I'm so sorry you are going through this. As long as your loved one expresses a will to live, stand up to hospice/palliative and fight for your loved one's right not to be written off because of their age.
If you don't, you'll never forgive yourself, I know.
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Hospice is wonderful for the individual as well as the family. Not to sound harsh but no one gets out of here alive. My SIL had stage 4 brain cancer a few years ago, we got her here to live with us a few months before the end. Everyone said hospice and she fought it. I am an EMT, in the ambulance on the way to the hospital with her after a fall at home my coworker told me she needed hospice. I felt the same way as most uninformed that it was a place to die. While in the hospital we finally made the decision when she could not. I experienced hospice when a friend died but that was as a visitor and when my grandfather passed I stayed with him all day and the night when he passed. When we arrived at the hospice facility it was a quiet place. The nurses are truly angles, really they are. They cared for her in a way the hospital would not (no attention at all in the hospital still ticked about that). They made her comfortable. There was no going back for her, she lasted 11 days but in as much comfort as could be given to her. For my wife it was very comforting that she was cared for in a quiet and dignified manner. They made sure she was not in much pain (morphine and other drugs were provided for comfort) even though we knew she was. If hospice is recommended then one should look at it, at home or in a facility. It is truly the best for the patient. Yes it is a place to die but in the most dignified manner. If there are any hospice nurses out there you truly have wings on earth!
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From looking at all this it looks to me like the important thing is to stay in charge. If your goal is not to have death occur as quickly as well as painlessly as possible, you don't just want piles of opioids and antipsychotics around the clock. They SHOULD be listening to you and giving you as much alertness as you want to have, and keeping any meds that help you function or feel better, at your discretion.
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My families experience w/ hispice wa incredible!! Our Mam was suffering and dying of Uterine CA, which had metasticized to her pelvic bones. She lived w/ my sister, for 5 mo.'s, with Hospice, aides, bathers, and Catholic clergy, as well as All the other 5 siblings helping, and Grandchilderen. I know, we had it really good w/the BEST possible support system, more than anyone could ask for, and still it was very difficult on us all as we knew we would lose her eventually, as we had just 14mo's before, lost our dear Dad (and my MIL), and were still grieving. At the 5&1/2 mark the Hospice nurses noticed subtle mental and physical changes in our Mum, and told us it was time to transfer her care to Hospice hospital, (I believe, sparing us seeing her die at my sisters home. (Its so painful at the end) our Mum was now ACTIVELY DYING. An absolutly lovely, caring, and comfortable place, w/a nice long couch for each of us to take turns, staying w/ her through the night. On day three, Mam slipped into a deep unconcienceness, and the Dr's and all family had a meeting to discuss now how to proceed. Their reccomendation was that they would discontinue all fluids and nutrition, except pain IV. This was it, time to wrap our heads around that we were losing her, that this would be her desire, as it had all been discussed by all, w/ Mam, when she was clear thinking and on DNR , and that is what we did. At first I had the most difficalty w/ it as I had worked in Medicine as a Medical Assnt. X 25yrs. Witholding fluids sounded cruel, but they assured me that it is in fact the most Humane thing to do, as she Was Clearly ACTIVELY DYING, and her poor body was clearly shutting down. They said, when a person's Kidney function ( BUN & CREATININE) WAS SO ELEVATED, as hers was, that it actually causes obvious confusion, But also actualy a significant pain relief and euphoria, that the pt. Benifits from, that it is well studied and doccumented, and I felt they truly were sincere, and would trust their word. Mind you, The long standing Morphine for her pain would continue. Our Mum was kept comfortable, turned, mouth swabbed w/ water, loved on, music, and all her six kids any all her Grandkids constantly around. The happy noisy she so loved, We had picnics, and I hope/know she knew we were all there for her. Mam was completely out for five full days. On day 8, at 6:00am ( Labor Day, No traffic into downtown Seattle) my little Brother 42, called us all, TO GET THERE QUICK, Mam had woken up and he was'nt sure how long she would stay awake. We each said Our Love and Goodbyes to her on the phone, and raced down there. Indeed she was still awake long enough to see our faces and tell her it was OK and to now join our Dad in Heaven, that we Loved Her for being the most Fantastic Mom, that we would all stay close and support one another, she could'nt really talk, but her eyes were filled w/expression and the Love she had instilled into each of us. And w/ all six kids hands on her, she slipped away. As hard as it was to lose her, it was a most Beautiful experience for us all as a family who rallied togather til the end to give back a little of what she deserved! We had a very simular experience w/ our Dad who had died just 14 mo. before, all togather at the end, he in hospital, dying from PSP, complicated by Pneumonia. NOW I have my Grumpy, cold, argumentary, hermit, Narcisistic, FIL living w/ my husband & I, in our home, X 10+ years since his wife passed away, and are at our wits end trying to figure what to do w/ him, and to get some quality of life back!!! YOU CANT WIN EM ALL!!! LOL. Which is why I am here, learning, as much as I can from all you folks!!! I so appreciate you all, everyone has Valid point of view!!! Hang in there, SINCERELY, staceyb1960
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I agree with "assisted suicide" or even "accelerated death". They do not treat things that are treatable - UTI, fever, headache - except to increase the Morphine. If I had it to do over, I would NOT have put my mom in Hospice. It is a decision I regret and cannot undo. May God forgive me.
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I completely agree with you, my dear Dad died because of being over drugged with dilaudin/morphine as well as being denied a feeding tube. He couldn't swallow because of a "mass" in his esophagus, which I believe wasn't even properly diagnosed. They immediately said it had to be cancer, from one ct scan.
It's inhumane the way our innocent, trusting elders are being ushered to their deaths by the very people who we trust to care for them. Of course a person will die if they are not fed for 3 weeks and given ever increasing amounts of morphine.
The way society is going, letting hospice/palliative kill off our elders is just barbaric. My Dad told me he wasnt in any pain but they said the morphine would make him more comfortable, when actually it made him unable to breathe and I too will never forgive myself. I think they took advantage of our trust in Drs/palliative and that we were under extreme stress. Its barbaric that they wouldn't even treat your Mother's UTIs, etc. except with morphine. It's Drs/palliative/hospice that should suffer the guilt over their selective extinguishing of the elderly. Just because they feel the elders lives aren't as valuable as a younger person's. I wonder if they'll feel that way when it's them lying there being drugged, and in my Dad's case starved, to a much hastened death. This slow death by sedation is nothing short of legalized murder and I don't know why we, as a society are not challenging it in the media. At the very least it would make people who have yet to deal with it not to be so trusting. I'm very sorry you are feeling so guilty, the guilt should be felt by those responsible, Drs/hospice, not you. I feel it every day too and its been almost 2 years. You did your best, please remember that. I'm so sorry about your dear Mom, and I'm so sorry for how they mistreated her. I hope you can find peace of mind knowing that we are only guilty of trusting the wrong people.
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Hi, I am also going through an end of life phase with my mother and am having mixed feelings about the 'process'. I am suspicious about the 'science' behind palliative care as at times, I must admit it seems to be more about ideology than medicine. Unlike, some of the other replies here, I am pushing to have more say about my mother's end of life care. For instance, When I have to push for even routine measures like the use of antibiotics, I'm reminded that we're not trying to prolong her life and I even find myself fighting with hospice, to allow her to sit up in bed ( even when she expresses the desire to do so). I can't help feeling that this is really about falling into line with the establishment, and the lack of real consultation is frightening. My strategy is to keep a close eye on all her interaction with 'professionals' and make them feel accountable for all their decisions.
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Yes! And YES everyone THINKS Hospice is so supportive, and that lets other family off the hook. That was my experience with my Father's death as well. I agree with you! First, Hospice took away any hope. Then they provided oxygen, with no monitoring of it, or training of us, just said, "if it looks like he's laboring for breath, just turn it up. Oh, by the way, if you turn it too high, he'll stop breathing at all." Also, once you have Hospice, you can't have anything that will "prolong life" like exercise rehab, breathing and throat/swallowing experts, you are all on your own for anything that will IMPROVE or even HEAL the various conditions. I tell my Mother, when I give her herbs, homeopathy, and tinctures, that yes, you have to die some time, but you don't have to lose all your faculties, and you don't have to go out in pain or with a confused mind.
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Plus, I have to say, Hospice is in some sense "a racket" in that they often times show up at the last week or so, hold a hand during the final passing, and then are the recipient of generous donations requested "in lieu of flowers..." etc., because people are so grateful for ANYBODY who isn't afraid in the face of death. But meanwhile, the caregivers and friends and community and wonderful medical professionals who cared for the person for years -- where are donations and gratitude for them?
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I personally can't wait until my husband gets to this point of needing Hospice. They are wonderful and they do ease the patient's pain and comfort that person. He is in last stage 7 all but he is still walking around and eating. He is basically healthy. But has every other symptom in Stage 7. It is probably going to be a long time in this stage for him! ( sigh)
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I agree with you about hospice as my own mother was left to die alone there with no family members wanting to go there to somehow make a better difference for her as everyone was informed that she was to die soon and also there was her bank account and a house and car to be up for grabs by my sister who cunningly tricked my mother into giving her the power of attorney over everything financially and medically ,so I did go to stay overnights there with my mother but I found out my mother was being drugged continuously with morphine every two or four hours non -stop and my mother could not speak nor move any part of her body afterwards but I believe she could hear me talking to her cause she moved her arms at one point back and forth together at the same time as if telling me to get her out of there then her eyebrows also were moved up and down but she could only have done this action after I had told one of the nurses to skip the dose of morphine for that time so I could at least try to speak with my mother before she died so she agreed to that dose of morphine being skipped for that time.I tried after that skipped dosage to get the next dosage of morphine stopped also after a few hours past from the first skipped dosage but to no avail this other nurse would not cooperate with me and went so far as to start an argument with me that she is the nurse and she is going to give her another dosage of morphine since she believes she is the only one trained to know the signs of pain and not me.so I told her if there were any signs of pain that I being my mother's concerned son would have heard and recognized that pain also and that there is no such thing as her being the only one to know signs of pain, but after that she still administered the morphine shot to my mother against my wishes and after that my mother was never again able to speak nor move and was also not given any food nor water for all the time of the three to four days she was there at hospice sedated with large doses of morphine shots and then she died a day afterward.
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It is not assisted suicide. But when you are ready, they do not prolong it at all! When you reach that stage, you want to be with your maker as soon as possible. At least that's how I feel about it. And it was discussed with my husband about 20 years ago when his first wife had a major stroke. He's children kept her alive. We decided then that was not what we wanted and we made out our living wills right away. I am so glad we did because it might have been more difficult as we drew a few years into Alzheimer's. But he always said the same thing. That was what he wanted and it is what I want too. He is now in his 12th year of Alzheimer's. And still basically strong and healthy! Just not much mind left. But the other day while I was visiting in the home, he looked at me and said, "What?" I looked at him and said, I just love you so very much!" He doesn't have much vocabulary, but I could see he understood. His eyes showed me. He managed to say, "Love you." What a treasured moment!
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I believe a lot of people misunderstand what hospice is, even my own mom in reference to my dad. Bottom line, hospice means the following: 1) a doctor believes you have about 6 months to live and/or 2) it is understood that that person does not want heroic or curing measures, but only to be kept comfortable. Now it does happen that people get better and then get "released" from hospice. My dad went to hospice last December, we thought he was a goner, then he got better in March, so he was off hospice, but then recently, two weeks ago, he had a lung infection, went to hospital, and while he was in hospital, was offered a feeding tube bc of his swallowing issues that he was told are too serious for any special diet to help (thickeners). The reason I give all this back story is that I think even my parents misunderstand hospice. When dad went in to the hospital, he was asked about his end of life stuff. He already has a DNR and knows he does not want heroic measures: no heart compressions or paddles if his heart stops, no breathing tubes, etc.. "to be kept comfortable" is the phrase docs use. This basically means you get a super low dose of morphine around the clock -or however you need it-to help you with pain and let you sleep. Also for my dad it helps relax his breathing airways. At the final end of things, what they give is not an overdose, just enough so that if you are about to die, you don't die anxious, in pain and fear, and feeling every bit of however you are dying. My dad will likely die drowning by fluid in his lungs. My most sad imagining is for him to die gasping and feeling like a drowning person, and anxious and afraid. I wish for him to be asleep and serene. He may not wish this, and I won't impose my way on him. They also provide, for my dad at least, people who come maybe 3x per week to bathe him in bed, which he really loves and appreciates. Ok, so.... flash forward to the day in hospital he was offered the feeding tube. He said NO. Just NO. Ok, so, at that point, he essentially invoked palliative care, since he's refusing the next doctor's orders regarding the next step to keep him alive. So he came home with hospice. Ok, so, then, my mom starts complaining about how the morphine makes him dopey and sleepy all the time. Well, that's "keep him comfortable" "palliative care" which is opposite of "curative care." So in my view, mom does not understand hospice either. "They just want to keep him doped up" she says. Again, Palliative care means doing no medical curing interventions and just keeping pain and discomfort at bay. Morpine and Ativan for dad. Ativan is for anxiety. Cause he's dying and that might make him anxious. If he weren't in pain, he would probably not get the morphine, but if he were anxious about dying he'd get the Ativan. _Of course_ the patient can change their mind about their decision to not have invasive procedures at any time. Dad did. But that excludes you from hospice. Dad decided he did want the feeding tube after he was described what it is--he hadn't even let the docs explain it in hospital. You have the right to change your mind till the day you die. But again, _not a hospice service_. He had to fill out a form today to get released from hospice so his insurance will pay for the medical procedure. Be sure you do this before you schedule a procedure if you're in hsopice, or you may fall through the insurance cracks and pay a whole bill! Once you get back to wanting to be cured of something, that's not hospice.
On a tangent, I had another set of relatives who believed hospice had "killed" their patient with a morphine overdose. But again, they misunderstood that, when a person is drawing their last breaths, the hospice way is to ease them unto death in a gentle way. The dose they give is not enough to kill a person who would not be dying. This is why it's such a controversial thing to legalize assisted suicide. If hospice were doing that, we wouldn't need to lobby for it, those who want it for themselves when the time comes. So in my humble opinion, as they say, Hospice is not at all assisted suicide. It is a gentler path to inevitable and imminent death. I hope I haven't stepped on any toes here, but I just have been dealing with this with mom and dad. One other thing: when you go into hospice, they discontinue a lot of the patient's meds. Not all, but many. I think anything that they feel is no longer helping, or crucial is eliminated, and they keep only those that would cause a sudden death sooner than the original disease from which he's dying. My parents ended up continuing some of the meds the hospital had canceled, and hospice still provides them. For free. So in his case the hospital seemed more aggressive in their expectation of his demise than our hospice. PS. I'm not a hospice worker or manager or in any part of that profession, I've just been so impressed by the level of care and compassion that my dad has received from them. and also the rest of us.
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My Dad was definitely killed by palliative care. He was given Dilaudid/morphine and died from fluid in his lungs. He couldn't communicate in the days before his death because the morphine makes it impossible to talk, or even move when it's given every few hours. The only time he semi woke was when he was gasping for air, drowning from the fluid in his lungs, he died a horrible death, struggling to breathe and looking into my eyes. I wish I'd never transferred him there. If this is the serene death some people are expecting, your loved one won't get it if they die this way, and if you're there to see it, you'll never never forget it and you'll never be the same. The elderly are written off, overdrugged and killed regularly in palliative "care" it's legal murder.
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It sounds to me like you have a very bad consultation. I'm a chaplain in hospice. It is not about shortening or extending life. It is about pain management and grief management along with maximizing quality of life for patient and family. Typically, with the hospice I'm with, nursing visits increase with each downward change in the patient's normal. My chaplain visits increase if I see a downward change in psycho-social issues in patients and or families. At some point, the RN/Case Manager will observe that death is becoming imminent. He or she will, in consultation with the hospice medical director and/or the patient's primary care physician (if they are different) begin continuous care. An LVN will be bedside 24/7 until death to maximize comfort to administer the best palliative medicine course necessary for the patient's condition. The only time I've seen patients unresponsive during this time is when they were already unresponsive when the regimen began.

I am so sorry that you had such a bad consultation. It sounds like you were consulted by a company that minimizes care in the name of maximizing the bottom line. Of course, I'm with a company that is willing to sacrifice a few bucks for the sake of patient care. We always ask (and only hire people who will ask), "How would I want my own husband/wife/brother/sister/son/daughter" treated and treat them in that way. If a doctor makes hospice referral to a specific company (without asking you) is also medical director of that hospice stay far far away. It's not only violating the Stark Act, but it shows me a hospice company that will engage in deceptive practices to get patients instead of letting their patient care speak for itself. Look for a company that has a robust and well paid chaplain and social worker staff who are not merely contingent labor. These are non-billable yet required (by Medicare) services. A company that values these roles values patient care.
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I read through these posts....and everyone seems to have missed the OPs original point.

Hospice wasn't going to be there....they were just going to have the medication to her and she would be left to administer drugs. Yeah, I wouldn't buy into that either. Hey....if hospice is there to help...then they need to BE THERE...not leave it to the daughter to handle it.

I have read a lot of posts from people who had a loved one on hospice...yet, at the end...it wasn't hospice there...it was just befuddled and bedraggled loved one...with hospice (maybe) on a phone.
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People die on the same time table whether Hospice is there or not.

With Hospice you know that your love one had a peaceful passing with very little pain. I use Hospice for both my parents, and everyone was so helpful and caring. They were an extra set of eyes and ears in the facilities where my parents had spent their final times.
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My brother past away last month after going into hospice. I would never suggest hospice for anyone. From what I gathered in Florida, a DNR, means no one can administer or do anything that may sustain life aside from the patient-ie feeding, eating, breathing, even an aspirin if it would increase your life time. Second, hospice requires a DNR. The DNR legally and willfully allows Hospice to NOT attend to your medical needs in any way shape or form. Hospice does not provide care medically in any way shape or form. There is nothing medical about hospice. Hospice from my experience showed the staff as confrontational, non-caring, not compassionate, liars, and do not perform pain management or any type of quality of care. My brother would have undoubtedly lived longer at home. He would have had better care. Hospice only came around every 12 hours or so, basically to check if my brother still had a pulse. My brother was to what I call nothing less than murder. It took hospice 8 full days to murder my brother. My brother was in agony and torment the whole time. Hospice care never showed up and did little to nothing to alleviate his pain. There was no dignity nor quality of life in my brother's last days. Family tried to take care of his needs the full 8 days around the clock while in hospice . Hospice did nothing. Hospice did have a plan to what they said was for pain but did not make adjustments to handle pain as it occurred for 8 days. i figure that 'pain' medicin is really the killer drug. Hospice lied to the family every time a question was asked. Hospice responses were lies and never answered even the most simple of questions. To me Hospice is required to kill you in x number of days. My brother was strong and it took several more days for my brother to actually die. I realize my brother's decision was his own and respect that, but wondered how many lies he was told before choosing hospice and the family knows of a few very big ones from the hospital and Hospice in Cape Coral. I am sure my brother expected more quality care and dignity than what this Hospice provided. I urge anyone thinking about going into Hospice to read up on what Hospice really provides.PS- Of course it is paid for by medicare. The government would rather see you dead than to have to pay out on your medical bills.
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There is no doubt to me that Hospice is assisted suicide, better yet- murder. Try and get a straight answer form Hospice. You cannot. All answers are are responded with- 'thonk of it like .." or some euphemism or metaphoric phrase.My brother past away last month after going into hospice. I would never suggest hospice for anyone. From what I gathered in Florida, a DNR, means no one can administer or do anything that may sustain life aside from the patient-ie feeding, eating, breathing, even an aspirin if it would increase your life time. Second, hospice requires a DNR. The DNR legally and willfully allows Hospice to NOT attend to your medical needs in any way shape or form. Hospice does not provide care medically in any way shape or form. There is nothing medical about hospice. Hospice from my experience showed the staff as confrontational, non-caring, not compassionate, liars, and do not perform pain management or any type of quality of care. My brother would have undoubtedly lived longer at home. He would have had better care. Hospice only came around every 12 hours or so, basically to check if my brother still had a pulse. My brother was to what I call nothing less than murdered. It took hospice 8 full days to murder my brother. My brother was in agony and torment the whole time. Hospice care never showed up and did little to nothing to alleviate his pain. There was no dignity nor quality of life in my brother's last days. Family tried to take care of his needs the full 8 days around the clock while in hospice . Hospice did nothing. Hospice did have a plan to what they said was for pain but did not make adjustments to handle pain as it occurred for 8 days. i figure that 'pain' medicin is really the killer drug. Hospice lied to the family every time a question was asked. Hospice responses were lies and never answered even the most simple of questions. To me Hospice is required to kill you in x number of days. My brother was strong and it took several more days for my brother to actually die. I realize my brother's decision was his own and respect that, but wondered how many lies he was told before choosing hospice and the family knows of a few very big ones from the hospital and Hospice in Cape Coral. I am sure my brother expected more quality care and dignity than what this Hospice provided. I urge anyone thinking about going into Hospice to read up on what Hospice really provides.PS- Of course it is paid for by medicare. The government would rather see you dead than to have to pay out on your medical bills.
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