Hospice while in skilled nursing?

I totally get that you are saying that they aren’t the same person anymore. I felt that way about my parents too. It’s so difficult watching our parents slowly decline.

My mom was on hospice before she died. She lived to be 95. She suffered with Parkinson’s disease and dementia. She would gladly have died sooner.

Both of my parents were ready to die. When a person has no quality of life left, it becomes torturous for them to continue living.

I am so sorry that you are going through this and your feelings are completely understandable.

Wishing you and your father peace as you continue onward in this difficult journey.

We are not medical staff working with your dad, so obviously we cannot hazard a guess to how long he will live. I think even the staff working with him would be loathe to do that, but the doctor may fudge it a bit to "guess" he has fewer than six months, and to order hospice. If he is still living after that Hospice can be reordered if Hospice agrees that this is basically a dying man. My brother's ex partner just died after one and one half years on hospice in his memory care unit.
VERY few services will come with current Hospice which is deteriorating rapidly. It is basically down to three baths a week and one RN visit, with, in my opinion recently, a fairly incompent social worker on the side. Skilled Nursing, if given because there is a need for skilled care (wound care and etc) will let you know if Hospice can be incorporated. You are correct that not everyone dies in hospice, but mostly they now have on offer a dropper bottle of morphine and little else, and they assume that you understand that the end of life is now the goal, not really healing. I would speak with the doctor; perfect one to answer your question. I am sorry that there are likely GREAT hospice organizations still out; my recent experience through a dying friend was abysmal. See Lealonnie's post in Discussions about hospice and read the article.
I sure wish you the best.

I am a firm believer that if there is anyway to get on Hospice sooner rather than later it is always a good decision.
It can not do any harm in calling a Hospice of your choice and asking for them to evaluate your dad. The worst thing is he does not qualify AT THIS TIME and they may suggest Palliative Care. This will get the team in an they can monitor him and when he does qualify the transition from Palliative to Hospice will be fast and seamless. the good thing is you will have extra sets of eyes on him watching for any problems.
You are right about the 6 months. As long as there is a "continued, documented decline" a person can remain on Hospice.
Make the call, you have nothing to lose.

A person has to qualify for hospice and your father has met that criteria. A person doesn’t have to be at death’s door to qualify.

No one can tell you when precisely someone will die. Nurses will update you on the condition of your father.

Best wishes to you and your dad.

Hospice nurses cannot say 'when' a loved one 'will' pass; only if they feel the elder has 6 months or less to live. Then the elder is reevaluated every 6 months to see if he still meets their criteria to continue with hospice services. People automatically associate hospice with 'death' which is not necessarily the case. Patients have been known to live for a couple/few years under hospice care; the day of their passing is determined by God, not hospice.

It sounds like your dad is suffering from 'failure to thrive' which is common when an elder gets to a certain age or after Covid or a long illness of some kind. They just wear out, I guess, and their bodies start shutting down.

I've had hospice care for both of my parents while they were living in Assisted Living and found their extra services to be of great value. They were given hospital beds, mom a different wheelchair she didn't fall out of, incontinence briefs, supplies, etc, all at no cost (but with Medicaid, dad isn't paying for these supplies anyway). But dad will also get a nurse to visit him, CNAs to help bathe him, a social worker and chaplain to visit, and services of that nature. It's an extra set of eyes on him that's helpful, for most people.

Wishing you the best of luck with a difficult situation.

The big question in my experience is “does the NH staff back off of daily caregiving needs in deference to a separate hospice staff doing these tasks?” Our home hospice experience with dad was great, a huge help. But when mom was in NH and hospice came on board it immediately caused the very good NH staff to back off. We heard a lot of “we’re waiting on hospice to come do it” that we’d never heard before. Things like baths were sidelined waiting on hospice workers. We canceled hospice, right away the good care came back with no waiting (maybe there were rules about who could provide what) and mom lived for well over another year.

I would say the COVID has weakened him.

Hospice will evaluate Dad and determine if he fits the criteria. If he is excepted they evaluate every six months. It could not hurt to have a second pair of hands. Just be aware, Hospice does not pay for his room and board. They only pay for supplies, durable equipment, prescriptions Nurse and Aide. Make sure when he is admitted you and maybe someone else is there with you. We all tend to miss something being said so nice to have a second pair of ears. Ask questions. Once admitted the Hospice nurse should be available 24/7 by phone.
Hospice is comfort care, not there to save Dad. Yes, some people do improve on Hospice. One members husband lasted 22 months on Hospice.