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Which best describes their mobility?
How well are they maintaining their hygiene?
How are they managing their medications?
Does their living environment pose any safety concerns?
Fall risks, spoiled food, or other threats to wellbeing
Are they experiencing any memory loss?
Which best describes your loved one's social life?
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I. How We Work in Washington. Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services. APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid. We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour. APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment. You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints. Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights. APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.I agree that: A.I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information"). B.APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink. C.APFM may send all communications to me electronically via e-mail or by access to an APFM web site. D.If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records. E.This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year. F.You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
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Do they have symptoms they want explained? Would they understand the diagnosis? Would they remember it? Or ask it over and over? Of course this would upset them. It would upset anyone. Do you think it will fill the rest of their life with distress? Are there other options for treatment? Is the patient able to understand them and make decisions about them?
I would have told my husband (I think). I would not have told my mother. I would probably want to know myself, but I really can't predict how I'd be if I had dementia.
This depends on the patient's personality, cognitive ability, symptoms, and perhaps prognosis.
Terribly hard spot to be in, as Jeanne says. YOu've gotten very good guidance.
I would only add have you read "On Being Mortal" by Atul Gawande? It's a great book when faced with choices and issues like this.
I would also get Hospice involved right away in a situation like this. Even if the prognosis is that the patient has more than six months to live, I would start interviewing various hospice providers to see what the differences in levels of service offered are.
I was very, very glad that we talked to the hospice provider that we ultimately chose well before mom needed them.
I wouldn't. Why upset them. Or they won't understand or forget. At that stage I couldn't explain anything to Mom. Her mind just went from one thing to another. Nothing you are going to do about it right?
they don't need to know they don't ask they show no interest in knowing
then no. What on earth for?
If
they ask they need treatments which have to be explained they cannot make sense of their surroundings without knowing
then yes. But use common sense and proportion, and your knowledge of the person's temperament and ability to understand, so that what you say to them is not confusing or needlessly frightening. Reassure them that they will be taken good care of, and that the doctors and nurses and caregivers know what to do, for example.
It is likely that the information won't stick, either way - if the person doesn't know what's happening, he will keep asking. If you have told him, he will still keep asking. One approach to this aspect of the problem is to find the form of words that seems to comfort him most and keep to that.
My dad is in this situation and I did not tell him. He most likely would not remember. He has lost a great deal of weight since diagnosis but doesn’t talk about that either.
I have come to this forum twice to ask if I should tell my mother bad news. I received great advice and comfort. The main thing I learned is there really isn't a right or wrong answer. Choose what you think is best, and then be ok with your decision.
My choice would be to not say anything. This of course depends on how cognizant the person is. If they are, what I would call "self aware" then maybe yes. If NO treatment will be done then there is no point in telling them. If some treatment is going to be done then the trips to the doctor or hospital are going to be stressful and that may require an explanation, over and over and over.
As you all know I am very pro Hospice and that would be my call. Contact Hospice have the person evaluated and I have no doubt that they will qualify. You will get the help you need from Nurses, CNA's Chaplain, Social Workers as well as equipment and supplies that you will need. Don't worry about the "6 month timetable that some say you must be limited to. As long as the diagnosis is "life limiting, no cure" and no treatments are being done the person will qualify. My Husband was on Hospice for a bit over 3 years.
Does this person have a POLST or DNR? The POLST is a newer version more detailed than the DNR? Had this person ever discussed what they would want done, or not done? Even a comment made about a friend or family member might give you a clue as to what their thoughts and wishes might be or might have been.
Not an easy thing to do, decide for someone a major decision like this. All you can do is think about what this person was like and let your heart guide you. There is no right or wrong answer. The answer might be different for each person. I know what I would want done and I have made my wishes known to my friends and family. So if you can take clues from this persons life, their discussions and make the best choice you can.
It in my estimation would be that if a person has dementia then it would be a REAL blessing to have them pass from cancer. It won't necessarily be quickly from dementia and the passing would for my wife be a blessing. She has Vascular Dementia and it is a slow moving slippery slope. God is blessing us during the times of stress although she doesn't know how stressful it is to hear her talking about the things when it is repeated or asked frequently. Prayer changes things, but it is for God's glory and not our own choices. HE knows what is best. Learn to live life for HIS glory.
I would ask what are you trying to accomplish. Are you trying to make her feel better? Understand why she's lost weight or is weak? And, are you willing to keep repeating what you tell her over and over, since, she won't likely remember what you said an hour later. I might run the scenario over in your mind and see what really seems kind. Since the brain can't process information, cause and effect, etc. normally, that information may not be helpful to her.
I am having difficulty with your question - didn't the doctor talk to him/her?
When my DH had Colon Cancer, his Cancer Doctor told us everything! He even drew me a diagram and told me I needed to keep it. 6 years later, at our last meeting with the doctor, I asked if I could throw away the drawing.
DH was stage 2 but it was right up against the wall - if they missed one cell, it would have all been over. But we were told, it was all explained. Didn't this person see a doctor?
At that level I would not have told my mom because it would do no good - the other factor is if any specific treatment could be worse than no treatment as can be the case - if she can't understand chemo then don't put her though it for just a few weeks more life that is hazy at best - however the majority of her family should be on board with this pathway
Keep her comfortable for now & let those who care for her make small good-bye visits so that she feels the love of all in her last weeks - forget doing anything but some pampering & a few indulgences like her favourite dark chocolate, flowers, coffees etc
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
A.
I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
B.
APFM may provide information to me electronically. My electronic signature on agreements and documents has the same effect as if I signed them in ink.
C.
APFM may send all communications to me electronically via e-mail or by access to an APFM web site.
D.
If I want a paper copy, I can print a copy of the Disclosures or download the Disclosures for my records.
E.
This E-Sign Acknowledgement and Authorization applies to these Disclosures and all future Disclosures related to APFM's services, unless I revoke my authorization. You may revoke this authorization in writing at any time (except where we have already disclosed information before receiving your revocation.) This authorization will expire after one year.
F.
You consent to APFM's reaching out to you using a phone system than can auto-dial numbers (we miss rotary phones, too!), but this consent is not required to use our service.
Do they have symptoms they want explained?
Would they understand the diagnosis?
Would they remember it? Or ask it over and over?
Of course this would upset them. It would upset anyone. Do you think it will fill the rest of their life with distress?
Are there other options for treatment? Is the patient able to understand them and make decisions about them?
I would have told my husband (I think). I would not have told my mother. I would probably want to know myself, but I really can't predict how I'd be if I had dementia.
This depends on the patient's personality, cognitive ability, symptoms, and perhaps prognosis.
Are you facing this? What a tough spot to be in!
I would only add have you read "On Being Mortal" by Atul Gawande? It's a great book when faced with choices and issues like this.
I would also get Hospice involved right away in a situation like this. Even if the prognosis is that the patient has more than six months to live, I would start interviewing various hospice providers to see what the differences in levels of service offered are.
I was very, very glad that we talked to the hospice provider that we ultimately chose well before mom needed them.
If
they don't need to know
they don't ask
they show no interest in knowing
then no. What on earth for?
If
they ask
they need treatments which have to be explained
they cannot make sense of their surroundings without knowing
then yes. But use common sense and proportion, and your knowledge of the person's temperament and ability to understand, so that what you say to them is not confusing or needlessly frightening. Reassure them that they will be taken good care of, and that the doctors and nurses and caregivers know what to do, for example.
It is likely that the information won't stick, either way - if the person doesn't know what's happening, he will keep asking. If you have told him, he will still keep asking. One approach to this aspect of the problem is to find the form of words that seems to comfort him most and keep to that.
This of course depends on how cognizant the person is. If they are, what I would call "self aware" then maybe yes.
If NO treatment will be done then there is no point in telling them.
If some treatment is going to be done then the trips to the doctor or hospital are going to be stressful and that may require an explanation, over and over and over.
As you all know I am very pro Hospice and that would be my call. Contact Hospice have the person evaluated and I have no doubt that they will qualify. You will get the help you need from Nurses, CNA's Chaplain, Social Workers as well as equipment and supplies that you will need. Don't worry about the "6 month timetable that some say you must be limited to. As long as the diagnosis is "life limiting, no cure" and no treatments are being done the person will qualify. My Husband was on Hospice for a bit over 3 years.
Does this person have a POLST or DNR? The POLST is a newer version more detailed than the DNR?
Had this person ever discussed what they would want done, or not done?
Even a comment made about a friend or family member might give you a clue as to what their thoughts and wishes might be or might have been.
Not an easy thing to do, decide for someone a major decision like this. All you can do is think about what this person was like and let your heart guide you. There is no right or wrong answer. The answer might be different for each person. I know what I would want done and I have made my wishes known to my friends and family. So if you can take clues from this persons life, their discussions and make the best choice you can.
When my DH had Colon Cancer, his Cancer Doctor told us everything! He even drew me a diagram and told me I needed to keep it. 6 years later, at our last meeting with the doctor, I asked if I could throw away the drawing.
DH was stage 2 but it was right up against the wall - if they missed one cell, it would have all been over. But we were told, it was all explained. Didn't this person see a doctor?
Keep her comfortable for now & let those who care for her make small good-bye visits so that she feels the love of all in her last weeks - forget doing anything but some pampering & a few indulgences like her favourite dark chocolate, flowers, coffees etc