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  • In home hospice questions

    We are checking out in-home hospice options for my father. I'm not really looking for recommendations on providers as he will not be in this immediate area, but rather what are the right things to look for and ask when selecting a provider?

    We will likely need a hospital type bed, so any recommendations or tips would be appreciated.

    Hopefully not many people have had to deal with this, but if you have and can share any pointers or lessons learned, that would be much appreciated. If it matters, he is over 65 so on medicare with supplemental insurance.

  • #2
    I am not sure the type of hospital bed is important. The biggest tip is to start hospice sooner rather than later. That might go against your instincts but talk to others that went through this...they we'll never say 'I wish we started it for my loved one later'.
    “Don't look at me in that tone of voice.”
    Ms. Parker

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    • #3
      Hi JJ, Sorry you have to go through this. I've just done this twice - although not in Frisco. Usually the hospital can make some recommendations for choices. Once you chose a program they will have a consultative nurse come in to evaluate the situation. They will order the needed equipment and even meds. My advice is to make sure you are able to spend quality time with your Dad without needing to taking care of ADLs (activities for daily living). I'm not sure of the underlying issues so it will vary greatly. Be sure to take advantage of all Palliative care including ADLs, massage, movement etc. Your job as best as you can is to make your Dad's time left as meaningful as possible. You should not become your Dad's nurse but rather be there for quality time. This is very rough emotional time for both your Dad and you- do not underestimate the psychological impact on both of you and the family. Death can be a beautiful, natural thing and does not have to be filled with drama. His sleep schedule will begin to get all whacky, plan to gave people or nursing staff take shifts. It's important you not only take care of your Dad but yourselves as well. Nurses are a whole new group of people that have NEVER heard your Dad's life stories.

      From a meds note - do NOT fear oral morphine. We struggled with beginning morphine and it really ended up making things worse. Oral morphine will allow your Dad more quality time (better breathing too). Yes there is some sleepiness BUT the awake time is much better for everyone. We planned awake time around the Cubs games.

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      • #4
        First of all ... I am so sorry you are having to go through this. My heart and prayers are with you. I had to personally go through this 2 years ago with my husband. We engaged with a wonderful hospice service and they were a godsend. Ask lots of questions ..anything that comes to mind; nothing is sacred. Also if the loved one needing the hospice care is able to participate with Q&A's let them. My biggest fear was everyone talking "around" my husband and yet he was sitting right there. The group we used spoke to him first and directed all their discussions surrounding their services and the choices he could make directly to him as if we were not in the room. We had changes to ask questions as well. Hubby wanted a hospital bed -- he got it. He wanted Depends -- he got it. He asked for oxygen -- he got it. Nothing was off limits. We knew his time was limited .. so we all made him as inclusive as we could and as comfortable as possible. Another important item, is to know your loved ones wishes for any type of resuscitation, etc. And post it where everyone can see it including visitors. Use all the resources the Hospice group has to offer .. don't let yourself get overwhelmed with thinking you have to do it all. I came really close to doing this and am thankful to this day that my sisters were here to pull me away and let the hospice nurse take over once in a while. What Mommyp said above out the meds is crucial .. looking back I was scared silly about the having to administer the oral morphine. I am so thankful again for the hospice team putting me at ease when it finally came to the point that the drug was needed.

        Hospice was 100% paid for by Medicare .. I never saw one bill from them ... ever!

        It's not something I ever want to do again .. but if I have to, I feel that I'm able, and capable, with the right Hospice group support. Sending a big hug to you.

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        • #5
          Sorry you have to go through this. I just did this back in April. Things to think about. As others have said hospice is paid for by Medicare so no out of pocket expenses. The company you choose ( we used Compass Hospice in Dallas and I can't say enough great things about these people) will coordinate with your doctor because you will need a letter stating that the patient is ready for hospice. Much to my surprise hospice is not a 24 hour care situation until the very end so you may have to still have to have some sort of in home healthcare provider which you will most likely have to pay for. Once in hospice only meds to make you comfortable are administered so any meds that were taken to prolong life are stopped. You don't necessarily have to be in an end of life situation to enter hospice so when you speak with your loved one assuming that they can communicate you can mention that it is not a death imminent situation necessarily. Once again I am sorry for yo having to go through this. It is very tough watching someone you love go down this path. Please feel free to PM me with any questions.

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          • #6
            Sorry to hear JJ.
            The only thing I'll suggest is to make every effort to meet with the person assigned. The actual caregivers may vary but it's very important to feel comfortable with the point of contact. Make sure they make themselves available and are easy to get in touch with. They should make you feel as comfortable as possible. Almost like a part of the family, not just another client.

            Actually, (I just remembered) it is your Dad who needs to feel the most comfortable with the primary contact. When I saw how much my mother got along with her, I knew it would be the best option. And it was.

            As far as a bed goes... that actually is very important. We had the type that lifts the back so my mom could get out of bed easier.

            Great previous comments.

            Prayers of comfort JJ.
            Last edited by lucas mccain; 08-28-2017, 09:42 AM.

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