I went through the hospice admissions interview for my mother yesterday.
I am writing about it because it is very much on my mind, but I also remember some other posts that were very well-received.
The first one was when she had her first knee replacement. Like now, I wrote about it because I was thinking about it a lot, but also it got an unusually high number of page hits. My theory was that other people had been researching knee replacements and shared it with family.
It came to me really clearly that there were lots of people dealing with the same things. My generation has aging parents. The first knee surgery was in December 2010, but that hasn't become less true. Some of us have lost parents, but some of us have that coming up.
If there are some things where reading about them now helps you understand better later, that's great.
It can also be good to remember you are not alone.
Mom was already in hospice once, so I learned a lot of this then. The first thing to know is that hospice is not a place. It is a medical status, so you are admitted and can be discharged.
The biggest change is that there is no longer curative treatment; everything is palliative. Instead of trying to change conditions you are trying to manage comfort.
A lot of the technicalities do with who pays for what. There are ways in which the hospice reimbursement is better. This is why sometimes you may feel some pressure to switch to hospice, though there are still medical conditions that are legally required to be met. These conditions are periodically re-evaluated.
I did write some about her first admission. It did not really seem like death was imminent, but there were all of these changes happening where we were not sure what was going on. When she was discharged from hospice, it was because her condition was stable and there was nothing going on that made it seem like she would die within six months.
Bear in mind that there are a lot of things that can't be predicted. If someone is in congestive heart failure, or really any kind of organ failure, there is a path you can trace. With strokes and heart attacks and aneurysms, there might not be clear indicators that something is pending.
Now there are more signs that we are getting closer, with that still being hard to pin down. Maybe weeks; probably not months.
In the time over which she was first admitted, then discharged, and now being admitted again, she never changed her location. She did have to change her care providers a few times, because of rules and things. That can be disruptive. If you are looking into choosing a health plan or an assisted living facility, it's not a bad idea to find out if they have the ability to provide hospice care.
(Also note that changing medical plans happens much more regularly than changing facilities, so while both choices are important, the facility is probably more important.)
Hospice can be a real help. The staff I have dealt with have been consistently kind and eager to help.
There is a gravity to facing death. Having people who are professional and experienced and don't have a lot of prior emotional investment to deal with can be really helpful.
It is true that a lot of the care is focused on the psychological and emotional aspects, like having chaplains on staff who can talk to people about regrets and things.
There are fewer guidelines to people who are riding it out all the way through the end stages of Alzheimer's.
That is our current location.
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