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N
nins Asked October 2011

How do you determine when to call hospice rather than hospitalize?

Mother is in a board and care. Has not eaten a full meal in 3 days and is now not urinating. Bloodwork not in yet, Dr. has ordered antibiotic for urinary tract infection, but she hasn't been able to keep pill down. She is 91 and does not want to go to hospital.-it is Saturday morning and they wish me to take her this morning. Any advice?

toheavensabove Apr 2017
the issues of hydration and nutrition are the next issue. i believe that intravenous hydration if dehydration is present is the most important though i do not know the standard treatment and i would rather not pass away do to thirst than nutrition . i worked in patient transportation for many years and noticed that comfort and thirst relief were able to help patients feel somewhat more content

vstefans Jul 2016
Well, it's my turn to notice how old this thread is, and the original poster does not appear to have been here since 2012 or so...but if still around, an update would of course be welcome!

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pamstegma Jul 2016
If they can't eat or pee or keep anything down, it is time for Hospital or Hospice. Your mother has made her choice, please respect it. If she dies without Hospice, the B&C has to call 911 and things will get dicey.

AlwaysH0pe Jul 2016
It definitely sounds like her body is beginning to show signs of decline. However, contrary to what some may believe, she can elect hospice care in order to avoid an indefinite hospital stay,(if she meets clinical criteria,) and still receive treatment for an infection should she want to be treated with antibiotics. The goal of hospice is to improve her quality of life in her remaining days....not to take away her choices for continued medical care. If she is admitted to hospice because she meets criteria today, yet gets better...her hospice care team would rejoice with her in her recovery, and in meeting her desire to stay out of the hospital!

vstefans Oct 2011
This sounds acute enough that she should get to a regular doctor - probably an office visit rather than an ER trip would make sense, if only it were a weekday! Maybe she would go to an urgent care center or her regular doctor would have someone on call who could advise. Three days of poor intake and probable dehydration does not quite make the case for hospice.

NancyH Oct 2011
I guess I'd call hospice and ask them these questions. I know that hospice doesn't HAVE to be just for people that are dying, but that's the usual situation. It worries me that it sounds like her body is shutting down, but her doctor should have known that don't you think?

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