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cbg1019 Asked March 2016

How to find out if my mother would qualify for palliative Hospice care?

My mother is 94 and not able to do much on her own. she needed help with dressing, bathing , toileting, incontinence etc. She recently fell and has a compression fracture on her spine and broke her arm. So now she can't even use the walker. She just contracted shingles and on top of all this, the dermatologist overdosed her on her antiviral medication and she had to go to the hospital because she was in some sort of coma state. She is in and out of it, sleeps most of the time now. After a week they sent her to a rehab facility. I would like to get her out of there. Still in and out of it, but I don't know if its because of the pain or the overdose. they only will give her acetaminophen. No other facility would take her because of the shingles. Is this something that palliative hospice would cover at home? It's very difficult because non of her family lives near her. She lives with a boyfriend who helps her and he has his own limitations.

staceyb Mar 2016
There is also the possibility of a Hospice Hospital, if your Mom is in or near a larger city. My own Mom went in patient to such a facility, and had a private room, and was treated very well, and with dignity and significant pain relief for those final 10 days of her life. She was previously in my sisters home, and on Hospice for 5 months. I would query her Dr for these sorts of answers, and call around to different Hospice providers in her area. There may be more options than you currently know of.

freqflyer Mar 2016
cbg, a person would be more comfortable at home [it's a personal choice], but you would need to set up the house like it was a nursing home. Hospital bed, lift, portable potty, grab bars, etc. If her boyfriend is also in the upper age bracket, would he be able to safely lift her so she can use the bathroom, bathing, etc? Would he be able to cook for her? Manage her medications? Do the laundry? If not, then your mother would need to hire professional caregivers, if she can afford to do that.

Otherwise, if your Mom is not improving in rehab after 21 days [Medicare will pay for the first 21 days] then your Mom will be moved to a nursing facility or long-term-care side of the rehab if that is available. The cost for her housing and care would be out of pocket... unless your Mom can qualify for Medicaid.

This won't be an easy decision.

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cbg1019 Mar 2016
We've been taking turns flying to see her. I've asked the doctor to give her something stronger but because she is not really aware they don't want to. I thought maybe I can get some other help also to help them at home. The place she is in is depressing. They put a bandage over her rash when she first got there and ended up reopening the scab. We are not sure if she is actually going to get any better so I feel she would be more comfortable at her home.

Windyridge Mar 2016
Cbg, are you dealing with this long distance? Have you been able to visit your Mom? It sounds really bad for her and now with the shingles also. I agree with Cwille about pain management. You should have hospice evaluate her to see if she qualifies.

cwillie Mar 2016
First, be aware that palliative care and hospice both assume that someone is nearing the end of their life and will not try to cure but only prescribe treatments in the interest of making the patient comfortable.

Second, even with hospice involved there will not be 24 hour care in the home, the bulk of the care still falls to family of friends (or in your mother's case the boyfriend). It doesn't sound as though going home is the best option for her right now.

Finally, considering the pain of shingles as well as the compression fractures, I wouldn't think that acetaminophen would adequately control her pain at all. She needs proper pain management, pain alone could be causing her to be "out of it", but at her age there may be many other problems you are not aware of. Are you her MPOA?

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