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Yes, he has issues, but the hospice companies say how it will free up the ALF’s staff. We pay for care from the ALF in form of ‘care points’. Why would I help them decrease their staff/resident ratio and still pay care points? All the hospice companies say the same things: ‘He paid all of his working life for these benefits, why not use them?’ and  ‘We’ll pay for all meds, incontinence products, devices needed, RN visits, ADL visits, etc.’ is this just a way for ALFs to have less residents to care for? Or, is this really a benefit to my father and our family with additional care for him? Thanks in advance for all your efforts and advice.

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I’m absolutely in favor of a person engaging hospice into care when it is needed.

I will be forever grateful for the care that my mom received from the hospice staff. They were fantastic!
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From your profile:

I am caring for my father Don, who is 89 years old, living in assisted living with alzheimer's / dementia, arthritis, depression, hearing loss, incontinence, mobility problems, parkinson's disease, sleep disorder, and vision problems.

About Me
Mom passed a few years ago from dementia. Dad had many falls and hospitalizations/rehabs until finally we moved him to an ALF. When we visit he just sits there, we do all the talking - he won’t play a game, do a puzzle, or engage. 

It certainly sounds like dad is ready for hospice and the extra layer of care they provide. When my mother lived in Memory Care Assisted Living and kept going to the ER and getting upset about it, we were both at the end of our rope. When hospice accepted her, I was so relieved I cried. Why? No more trips to the ER for useless poking and prodding sessions which did no good for either one of us, no more taking useless vitamins and supplements that did no good for her....just being left in peace and medicated as needed to relieve her anxiety and agitation. A hospital bed to sleep in. A new wheelchair with a higher back that tipped back and stopped her from falling out of it. A device in the bed that sort of cupped her body, making it much harder for her to get up alone and fall out of bed. Visits from nurses and CNAs to bathe her, chaplains to pray with her, social workers to chat with her and visit. The RN kept in close contact with me and would adjust her meds according to her rollercoaster moods and needs. Hospice doesn't cut down the work the AL staff does,,,,,they ENHANCE it, all in an effort to make your father more comfortable and ease the final days, months or years of his life.

Those who insist hospice is useless or money grubbing thieves or whatever have no idea what angels look like. Both times hospice has been a huge help to my parents, and to me, in making our lives easier. In fact, the hospice chaplain married my son in front of dad's hospital bed in his AL room a day before he died. It was an unforgettable experience for all of us, and there wasn't a dry eye in the room.
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I don't see where Hospice would take place of the AL aides. Yes, you get an aide 2x a week to bathe, but thats it. The nurse is once a week or so. She just takes vitals and answers questions. Does Dad need morphine, anxiety meds? When Hospice is not there the AL aides will need to still be there.

To me, if Dad is not showing signs of transitioning, I would not bring anyone strange into his life.
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My mother, who lives at AL/Memory Care was on hospice for 2 years, then she graduated out of it.

While she was on hospice, she had many more eyes on her than she does now:
Nurse 1x/wk.
Bath Aides 2x/wk
Chaplain 2x/month
Social Worker 1x/month.

It was the chaplain who discovered that Mom had fallen and opened up a long gash on her forehead and down her face. I appreciated that the chaplain paid extra attention, and didn't just peek in and assume that Mom was sleeping.

I would definitely bring them back on-board, if Mom were to qualify again. I had a new company come out and check on her, but she doesn't qualify, yet.
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Hospice is END OF LIFE CARE.
The for-profit hospices now are crowding in for their share of the almighty dollar and will do anything to get it.
For all that they give an aid a few times a week, the GOOD meds, and a Social Worker who calls you once. An RN once a week who takes the blood pressure. And for that they charge medicare a ton of money.

What is left out here is DOES YOU FATHER NOW WANT END OF LIFE CARE?
Do you want it for him?
Mind you I am an old retired RN who LOVES hospice, as least as it one was, not as it is now.

Because we have occasionally seen Hospice deliver medications that some families feel did a bit of a speed-up on the Grim Reaper at the door. That's a good thing, to my mind, at the end of life. But if you aren't saying now that this is the end, and that it's accepted? Then tell them to stop these calls or you will report them to Medicare, and that will be the end of that soliciting.
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ElizabethAR37 Mar 1, 2024
Couldn't deliver the GOOD meds too fast for me when/if I have reached hospice qualification status! Which prompts a question: how does one "choose" a hospice? I would guess that NON-profit would be far preferable, if such a thing still exists. Putting my EOL in the hands of a private equity fund holds no appeal. I have hired an aging life professional/geriatric case manager for a one-time consultation. I hope she will be able to provide direction/information in several areas, including hospice.
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If your dads ALF is suggesting hospice, they must believe that he is dying or will be dead within 6 months as that is how one qualifies for hospice services.
You fail to mention that in your post. It may be because you don't want to accept that your dad might be nearing his end???
But getting back to hospice, yes your dads Medicare will pay for all needed equipment, supplies and medications from hospice, and they will have a nurse to come out just once a week to start(more as he gets closer to dying if you get a good hospice agency)and aides to come bathe your dad twice a week.
So as you can see, your dads hands on care from hospice will be quite limited, and he will still require a lot of hands on care from the team at his ALF.
You can look at it as having extra eyes on your dad as he takes this final journey.
Just know that not all hospice agencies are created equal, so definitely do your homework before bringing one on board.
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Oh my gosh. I think you have the wrong idea about hospice care.

Hospice care is about keeping a patient comfortable in their remaining days.

I will always be grateful to the hospice staff that cared for my mother.

Please be selective about the provider that you choose if you decide to attain hospice care. Do lots of research before choosing. They are not created equally.

Best wishes to you and your family.
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Kathyintex Mar 1, 2024
Need help with mom -
I am familiar with hospice service/care. My mother was in hospice the last two months of her life - she needed it and we didn’t hesitate to get her that extra care.

The reason I wrote the post/question is because I am stumped why I am receiving these calls. My father is not at end of life (but who knows). The companies sent me several different lists for ‘qualifying’ for hospice and actually he does qualify under a few different ‘lists’ - but my question is whether or not it’s really to his benefit? Each company says that hospice is not just for end of life, and tell stories of people being on hospice for a couple of years and some even ‘graduating’ from hospice (as one person on here has responded already that was the case with her LO).
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I asked the same question when the Assisted Living Facility wanted to call Hospice at the very last minute when it was clear my dad probably wouldn't live but a few days. I wondered what Hospice would do that AL staff wasn't doing/couldn't do and they said that having Hospice wouldn't change his care but it would change what they had to do after he died. Without hospice they would have to call the rescue squad, even though he was dead, because he'd have to be declared dead. That meant the ambulance, the EMTs, etc would all descend. With Hospice they would notify Hospice who would then notify the funeral home and it would be taken care of with some solemnity and dignity. AND they were right. My dad died about 2 hours after I signed the hospice paperwork. He was able to be in his own bed as we waited for the funeral home staff. They were very professional at removing his body with the least disruption to anyone. SO, for his care nothing would change but for his death hospice was a blessing. Also, if you want to have him die at home you'll need both a DNR and a DNT (Do Not Transfer), which I'd never heard of. That says that the AL is NOT to allow him to be transferred to the hospital. It's different than a DNR and eliminated any possibility of someone calling the rescue squad.

I had hated hospice when my mother was dying and I thought it totally unnecessary for my dad, but at the end I was really glad I'd signed that paperwork.
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Kathyintex Mar 1, 2024
Thank you - sorry for the loss of your father, but the info on the DNT is good for me to know. Thank you again.
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Hospice is great! I loved my daddys hospice plan and people. I did not like my sisters plan - the people were great but the plan sucked. Hospice does pay for insentience supplies and other things that he may need they are also more reliable and responsive - in my experience.
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What is your dad’s condition that qualifies him for hospice?
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Kathyintex Mar 1, 2024
According to the different hospice companies he qualifies under a diagnosis of mid-stage vascular dementia, complete incontinence, inability to complete most ADLs, wheelchair bound, etc.
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