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jhorta Asked February 2021

Any advice or suggestions on transferring hospitals?

My father was previously on hospice at home but had breathing complications and was taken to emergency. The hospital indicated dad had pneumonia and part of the reason was the medications he was being given by hospice.


Hospital is currently treating him for the pneumomia but dad has other issues. Mainly throat problem he complains of pain and unable to swallow. Staff there just seems uncaring. Hardly check on him, and just not treating his painful throat problem.


We want to take him to another hospital. The hospital he is at is a regional hospital and its is about 2 hours away from Los Angeles and we would like to take him there. Any advice, suggestions , comments much appreciated.

jhorta Feb 2021
Yes. All replies comments taking well. I just see he is still in there. He acknowledges me, he answers my questions, i don't know that he has Alzheimer's. Yes, he is absent minded at times, but other times he is there. That's why it's hard. Alzheimer's, or even dementia have not been confirmed by any doctor yet. He has not been diagnosed with that to this date. Soo hard.
Isthisrealyreal Feb 2021
Then you should change your profile. Because you have provided incorrect information and that will impact the answers you receive.
Grandma1954 Feb 2021
Please know that there are MANY drawbacks to having a person with dementia put under anesthesia. There is a very good possibility that he will not return to his current "base line" cognition.
Depending on what other medical conditions he has the last few days, weeks of his life may be spent in a hospital probably on machines keeping him "alive"
Is this what he would truly want?
The pneumonia that he has is probably Aspiration Pneumonia. This happens when food, liquid is aspirated into his lungs. This is a very frequent occurrence with dementia. At is basic, there is a flap that closes off the airway and allows food and liquid to go down the esophagus. With dementia the body does not recognize some foods and liquids so the flap fails to close allowing food to enter the lungs. Thickening thinner foods, liquids, avoiding slippery foods helps but careful monitoring when a person is eating is necessary.
I would think long and hard about putting him through any surgery.

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Isthisrealyreal Feb 2021
I am truly sorry to hear that you are going to put a 90 year old man that has Alzheimer's through a surgery.

Please seek counseling for yourself, because you can not keep him alive forever and in my opinion, what you are doing now seems cruel and for you. This is not about him any longer, because Alzheimer's steals the person we knew, with no hope for recovery.

AlvaDeer Feb 2021
With your decision now to have shunt (?) placed into brain, your Dad is being "treated" and that makes him ineligible for Hospice. I agree with RealyReal that you may not understand that hospice mean end of life care and comfort care only.
You don't get pneumonia from medications, though some meds can suppress breathing keeping one from fully airrating the lungs.
As to which hospital, there is little choice in that. You Dad can likely only be transported by ambulance at this point; that would be to a hospital near you. I think you would not want to pay for heliocopter transport to another hospital, something not covered by insurance, and very costly.
I wish you good luck.

jhorta Feb 2021
Thanks for all replies. Dad is now out of hospital and home. We have decided no hospice for now. Gone try progress health and plan for surgery to remove liquid in brain. Dad disoriented and maybe this will relieve symptoms of cognitive deficiency.
worriedinCali Feb 2021
Your dad has Alzheimer’s. You can’t fix his brain even if you drain fluid from it. You should be focused on his quality of life Instead of prolonging his suffering.
EmotionallyNumb Feb 2021
Is he on hospice still or not? Not much point in him being in the hospital if he's on hospice. Hospice is for comfort measure, not treating the illness. Not sure why he would be taken to the hospital for breathing issues if he's on hospice. The staff are likely confused about what your goals of care are. You understand that hospice means he is expected to die in six months or less, correct? By signing with hospice you are agreeing to not continue treating illness and only using meds for comfort purposes like pain control or breathing.

It's very difficult to get a lateral hospital transfer, especially if the patient is on hospice. Not to be crass but what would the point of the hospital transfer be? It sounds like your family, your father, the doctor and the hospice agency should have a care meeting to determine what your plan is.

JoAnn29 Feb 2021
Hospice usually does not allow hospital visits. Thats the whole purpose of Hospice. To allow someone who is dying die in comfort. Pnemonia can happen because he is bed bound and not moving around.

againx100 Feb 2021
This seems a bit confusing. Is he on hospice and being able to let nature take it's course, with proper pain management so that he does not needlessly suffer? Or is he being actively treated to try to cure him and prolong his life? I guess you need to clear this up. Regardless, his pain needs to be treated ASAP. No need for him to suffer.

BarbBrooklyn Feb 2021
I'm confused.

Your dad was on Hospice (what was his life limiting condition that qualified him for Hospice services?).

Hospice is about comfort, not currative care. Pneumonia is often called "The Old Man's Friend" because it is a relatively easy way to die, especially with comfort meds given.

What does the DOCTOR at the hospital say about his throat pain? The staff can't give care that isn't ordered by the hospitalist.

If he has swallowing issues, has he been seen by a speech language pathologist?

Isthisrealyreal Feb 2021
Jh, who made the decision for hospice?

You do understand that hospice is for people that are terminally ill and have decided that they no longer want treatment to help prolong their death?

This is probably why you are not seeing great treatment. They understand that hospice is intended to stop all the poking and prodding and needless, fruitless treatment.

Please talk to your dad and find out what he wants, because someone decided that he would no longer get treatment. Pneumonia is not the worst way to leave this old world.

I am sorry that you are losing your dad. Please speak with someone that can help you understand this and exactly what hospice does.

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