My 94-year-old father-in-law resides in assisted living, suffering from congestive heart failure that led to 4 hospitalizations in 2024, severe pain from spinal stenosis (treated for 6+ years with a fentanyl patch), and GI bleeds that land him in the hospital with severe anemia at least once a year. He has just been hospitalized again with blood pressure of 190/114, and I predict the same outcome: medication adjustments that will do the trick for a few weeks, and then more of the same. Meanwhile, his cognition and quality of life seem to diminish by the day. At what point, and how, do loved ones broach the option of hospice, or at least palliative care? He does not like to be "managed" and seriously thinks we should be planning a European river cruise right now, not his funeral.
It probably should have been discussed at the second or third hospitalization in 2024.
Ask for a consult with the Hospice. Most hospitals have a Hospice or an admission nurse for a Hospice they work with is on site.
His ALF may also have a Hospice they work closely with.