I'm sure this has been asked before but how do you broach the subject of hospice to your declining loved one?

I dont think they need to know the Hospice Nurses came into see my brother at the end . They tried seeing my Mom On December 8 , 2016 and then she refused and she got sick on Christmas and died 2 and a half weeks Later , she would have been better off with the Hospice nurses .

My mother grew tired of all of the doctor and hospital visits. A home health nurse said not to wait until the very end to consider hospice.

Mom started off with palliative care and then progressed to hospice. She was ready for comfort care and was more than ready to leave this world.

Hospice is all about keeping a person as comfortable as possible. They provide a social worker and clergy for everyone if desired.

I highly recommend an end of life hospice facility or care home if one is available.

First of all.. you ask his doctor for palliative care and hospice care evaluation…
you tell mom and dad it’s just added support system for dad.. you’re just stating what is usually offered. Obviously mom and dad, we need this extra layer of support care. It’s okay.
Hospice is supposed to be end of life care, but mom graduated out of hospice 3 times.. so.. the third time she went to heaven.
It’s ok… put the blame on his doctor..

Here's what to say to convince Mom to go with hospice:

*He doesn't have to go to doctor's appointments anymore. They'll come to him from now on.*

There are plenty of other reasons to go on hospice care, but that one alone is the biggie for a lot of people.

Hospice will not try to kill him, and they won't withdraw his medications, but they will focus on his quality of life, a large part of which is dependent on getting relief from those fissures. My mother was on hospice for eight months, and she was treated for terrible pressure sores the entire time. She was in no pain, and her hospice nurse was a godsend.

Ask him. If you feel strong enough, you can have this conversation. He can meet with a hospice consult and choose....not your mom. I have dealt with hospice 3 times. My aunt asked me about it first. She was ready before I even had a thought about it. With my mom, a hospitalist asked me. I was both proxy and guardian. Again, I requested a consult.

Most of the responses were kind and helpful. Thank you to those of you who were. I actually asked him today if he feels up to more doctors appointments and he said, “Sure!” so I guess I have my answer for now. After reading the responses and the more I think about it, the more I think he would have a negative response to talking about it (yet) so I’m glad I brought it up here. Thanks again and best of luck to all of you.

Yeah, I'm guessing your dad is going to figure this out all by himself.

My dad was fully aware of his condition, which was cancer. He had dementia but was deemed competent to make decisions for himself. His oncologist approached him about hospice, and dad signed himself in.

Mom was deep into dementia and as POA I spoke with the hospice people and requested hospice. She never was told she was in hospice. She understood that she was getting extra home help and that was okay with her. She was also grateful that visits to the ER were over. She was in hospice for 2.5 years, but they kept dropping her, then taking her back. That was a mess.

Are you POA or is mom? If it’s mom and she’s reluctant, I suggest asking the doctors to talk to her about it. She may have a skewed idea of what hospice really is. If it’s you, do what you think best for dad. You don’t need mom’s concurrence.

As for dad, he may not need to know he’s in hospice, depending on his cognitive abilities. His medical team can advise about that.

So sorry you’re facing this.

We never know for sure how we'll react or what will happen at EOL until we're actually there, but I sincerely hope no one will have to "broach" hospice (or palliative care) to me at that time. If/when I become seriously compromised health-wise and am approaching EOL, I hope I can/will indicate, as firmly as possible, "bring it on" to hospice, wherever and however these services can be provided at least disruption to my family.

My written directives spell things out pretty clearly, and I have prepared a personal letter as well. Literature on MAID and VSED can be easily found in our home, so there should be no doubt as to where I stand as of today while I am fully competent mentally--but less so physically.

Hospice is not a death warrant, nor does it mean dad is going to die within the next 6 months. What it does mean is that he will stop schlepping to hospitals and getting poked and prodded or waiting for a bed for 2 days in the ER. He'll get comfort meds for the pain he's suffering, a CNA coming in to bathe him a few times a week, an RN coming in to examine him once a week to start, a chaplain, a social worker and lots of medical supplies and a hospital bed free of charge. Everyone automatically thinks immediate death when they hear hospice, but what it is, in reality, is an extra layer of care for dad and for mom.

So, when I had to approach dad about hospice I was nervous. We were in the ER and he'd just had a brain MRI that revealed his brain tumor was growing and causing him mobility issues. He was terminal at that point, nothing could be done for him medically to extend his life. I told him that there was no meds or surgery he could get for the tumor he was aware of, and that while it was considered terminal, he could easily live for 2 years with hospice comfort care. He was solemn, but accepting, at 91 years old. We went back to AL to tell my mother, who took the news well.
Hospice and the carers at AL took good care of dad, but he passed 19 days later after getting a bad UTI.

Mom was in Memory Care and vehemently opposed to dying, period, no matter she was 95 with advanced dementia and CHF. In her condition, I didn't even tell her we'd brought hospice on board, and she had no idea. She passed 2 months later and neither mom or dad were given morphine until the very end of their lives, which I approved.

Best of luck with a difficult situation.

It sounds like your dad would definitely qualify for hospice care. Often it is ones doctor that will recommend it to either the patient themselves or the patients loved ones.
And I know that hospice also has folks that will come out to the home to explain the purpose of hospice to your dad and mom and then let them decide if it's right for them.
Hospice will have a nurse to come out once a week to start(more if your dads wounds need to be treated)aides to come bathe him at least twice a month, and you all will have access to their chaplain, social worker and volunteers.
Also they will supply any needed equipment(like hospital bed), supplies and medications all covered 100% under your dads Medicare.

My late husband was under hospice care in our home for the last 22 months of his life and was completely bedridden at that time. And to be honest I'm not really sure that he understood that he was under hospice care and that it meant end of life care as my husband had vascular dementia.
I know that often folks wait too late to bring hospice on board. So I would recommend perhaps calling your local hospice agency and ask them to come out to do an assessment and they will be very helpful in answering any questions you and your mom may have.
The bottom line with hospice is that the patient is kept as comfortable and pain free as possible until they leave this world for the next.
And I'm sure that is all you and your mom want for your dad at this point in his journey anyway right?

Basically you should by nowknow how much your parent knows about Hospice?

Are your parents expressing to you anywhere in all of this that Dad is "over this", "tired of this", "doesn't want to go to the hospital anymore", "doesn't want treatment anymore", "exhausted", and such like statements?
Because if he is NOT, then he really isn't asking now for end of life care, which is what Hospice is.

I will give you an example of my Dad in his early 90s. He told me he was quite tired of life. That he had had a good one, but that he longed now for the "last long nap". That it was a burden for him to have my mom trying to cook good meals, getting him on the scale. That he didn't want blood work for a mild anemia because he didn't want "to do anything at all about what may be causing it." That, in fact, if docs tried to treat him I should stand between them and him with a gun. I had many patients tell me this themselves, but saying often they could not speak with their families because they weren't ready to hear it.

These kinds of statements I wrote, you would be hearing from someone ready for Hospice.
If you don't hear them you should be VERY LEERY and very careful about bringing up END OF LIFE care which is what Hospice is. Many people do not EVER accept they are dying and do not EVER want YOU to accept it, nor do they wish to speak about it.

You can approach the subject with "Dad, you have been having lots of tests and appointments and treatments of late. How are you feeling about that? It must be exhausting".
Then stop, look and listen as they tell the kids in school.

And take it from there.
Otherwise, it is up to the docs to suggest, to ask questions "What do you want if...." or "we can try this or that, but if you don't wish to we can keep you comfortable at home" or "There isn't a whole lot we can do now to improve or change things.....".

As a nurse I can tell you that most people do NOT REACT WELL to others telling them it is time to give up. And that is, whether you say it nicely or not, what Hospice is. It recognizes the reaper is at the door, and it is a determination to let him in. And that doesn't come to all people.