My Grandmother has suffered a series of falls, starting in Nov 2016. She has a broken C1 vertebra (this will never heal, she will remain in a C collar for the remainder of her life), a broken L7 vertebra in her back (same situation, back brace) and has had 2 significant brain bleeds (most recent one on March 28 2017). She was living at home after a 5 week stay in between a hospital and rehab stay discharged Dec 30 2016. But, has been progressing on a down hill slide. This most recent fall hospitalized her for 4 days (comatose) and she is now in a skilled facility to receive rehab once more. She continues to decline, will not eat, drinks very little and is refusing rehab treatments. She in her words not mine "Is tired and weary, and just wish She would have died the last time she fell". She was found after being unconscious for approx 6 to 8 hours. Believe me, no one is in her corner more then I am to fight for her. But, at this point I am more concerned with her comfort then her rehab. She has zero quality of life. She is bed or wheelchair bound and can only get up or move with assistance. She will never make it back home. She has bone cancer (2001) that has been held at bay by monthly infusions. My question is a few parts
When is it the right time to consider Hospice?
Can she go under hospice and if she does start to get better, go back into a rehab facility?
Do people "give up" once they get into hospice?
Let me state again, I do not want anything but the best for her, but at the point she is at I am most concerned with her comfort not getting her better. I would love nothing more for her to gain some will back and recover, but her attitude and her health just don't seem to be cooperating with her at this point. I don't want to give up on her, but I am also not going to stand by and watch her suffer anymore. My uncle lives in another state, and while he does not prevent me from.exploring options for her care, I truly don't believe we are on the same page as far as her condition. I see her continually sliding down the hill, he only sees her for a few days every few months so he doesn't see the day to day decline. I, in my heart, feel she is not going to pull out of this one, and want to make sure that everything is being done to keep her as happy and comfortable as we can until the end, whether it be weeks or months from now. Am I wrong to think like this? And who do I ask for more information on Hospice? Her Dr? Her social worker?
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My husband was on hospice care 5 weeks before he died.
My mother was on hospice care 3 months at which point she had improved so much she was no longer eligible. She lived another 2 years.
Your Gram is going to die on her own schedule. Hospice neither prolongs her life nor shortens it. It only makes the final days more comfortable. And if the final days are not really final, it makes the period of healing more comfortable.
If Gram is mentally competent and she decides she wants hospice care, I think that overrides anyone else's opinion.
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I myself recommend you discuss Hospice with her providers. She may be in a great deal of pain and not feel like giving rehab another shot. Either hospice or palliative care. In making your decision her quality of life should be a priority in your decision. You have said she doesn't have much right now.
Yes people can transition out of hospice if they improve. My mother was in hospice twice; the first time she rallied and improved enough to be discharged from hospice; the second time she began to have a series of strokes and I saw a huge decline and brought them back. It was a year between hospice episodes. During the first episode she received spiritual care, they sat with her and played soothing music or big band music according to her mood and she benefited enough to be discharged from hospice.
I feel for you regarding your uncle - is this his mom? Every family member seems to want to put their two cents in, while you are on the frontline fighting for her daily. You are the one who hears her say "she wishes she had died" after the last fall.
Does she have a DNR or Living Will? That makes it easier. My mother did not. Unfortunately she never wanted to discuss end of life issues with me EVER, so my brother and I worked together as she left no guidance.
She needs rest now and needs to be comfortable emotionally as well as physically. She may dread another course of rehab but is going along with it because her family wants her to.
I hope things get more clear for you in the next few days, and for your uncle too.
Are you her POA? Or is uncle? Does she have a DNR or medical directive?