Hospice advise in Nursing Home. My dad was diagnosed with vascular dementia 3 months ago. After an ER visit for confusion Dr said he was moderate (2 out of a 10). Well, 3 mths later, he had a septic infection that caused his dementia to worsen. He's been in the hospital for 1 month ( took out artificial knee causing infection and replaced with a spacer filled with antibiotics). Long story long, he is in a Long Term Acute Care facility. He is always sleeping and hardly eats. He has problems swallowing so he's on necar thickened liquids. The Dr. has asked us about Hospice. I am trying to process this as the dementia has progressed so quickly after the infection.
My mom was moved into a nursing home 2 weeks ago so I think he should be close to her instead of a hospital.
I would appreciate any advise on this topic. Thank you!
My husband was on hospice, at home, for 5 weeks before his death. It was extremely helpful for both of us. I wish we'd signed up for it a little earlier, but the time we had it was very worthwhile.
My mother was on hospice care for about 3 months, in a nursing home. The extra care and attention she got because more resources were available (NH staff + Hospice staff and volunteers) were very helpful. In fact she improved so much that they discharged her from hospice. That was a year ago. She is doing well, considering her chronic conditions.
Obviously I don't know your entire situation but from what you've said, it sounds like it would make sense to move Dad into the same care center where Mom is, and to apply for hospice care. Recovery from the septic infection and the trauma of the hospital stay takes a long time in the elderly with dementia. Who knows? He may gradually improve some while on hospice care. To go on hospice means the doctor has predicted that he is in his last 6 months of life. But nobody can make an exact prediction. Maybe he has more life ahead of him, as my mother did/does. Maybe the rapid decline will accelerate and he will die soon. In either case, I see only good coming out of hospice care for him. And it can be comforting to you and to your mother.
My mother has been living with dementia for probably about 5 years. My husband lived with it for 10 years. Runner123, that this has all hit you in the past 3 months must be almost leaving you numb. My heart truly goes out to you. Keep in touch here, and let us know how things progress. Take care of yourself!
In the final stage of this disease, individuals lose the ability to respond to their environment, to carry on a conversation and, eventually, to control movement. They may still say words or phrases, but communicating pain becomes difficult. As memory and cognitive skills continue to worsen, personality changes may take place and individuals need extensive help with daily activities.
Require full-time assistance with daily personal care
Lose awareness of their surroundings
Experience changes in physical abilities, including the ability to walk, sit and, eventually, swallow (mom stayed on this for 14 days before she died)
Have increasing difficulty communicating ((Mom perked up a month before death, but I was carrying her around within 15 days of that)
source I have used: http://www.alz.org/alzheimers_disease_stages_of_alzheimers.asp
I opened this email hours after getting a call from my husband's hospice care manager that he had fallen during dinner and had hit his head on the dishwasher door. Slight bump but no lapse into unconsciousness. This was after a noontime call that his left hand is swollen and tender. Do I want an x-ray and if it's broken, do I want the had casted.
He has been in the final stage of Alzheimer's disease since December. He doesn't speak intelligibly, he doesn't recognize me or anyone else, he does feed himself and he walks. He walks all the time which is why he now is gettng weaker and falling. The workers complain if he is medicated and lethargic. They complain if he is agitated and constantly walking, needing someone near him to prevent him from falling.
This is indeed such a sad time and no one knows how long it will continue. He has been out of my home for 4 years now. I would leave your Dad in the Long Term Acute Care facility for several months and only move him if he becomes stable. He will get the most care there. I would bring in hospice as they are such caring people and so helpful and take each day one at a time.
My experience with hospice was vey helpful. Unfortunately I had to fire the first hospices company and by the time I did my mom had 3 days with the second one. Be there for them till the end. Invite close friends to visit and family. Say what you have to say before they are at the active dying stage. Remember the good times and reminisce and take pictures. Above all take care of yourselves by exercising and eating healthy during this challenging time. I did go an Excersise every chance I got. It helped me to clear my mind and helped with stress.
Hugs to all!
avoidablecare/wp-content/uploads/2012/04/Sharpe-Handbook-A-Caregivers-Guide-to-Advance-Dementia.pdf
My LO had to have stints in heart arteries and that was necessary - but it really took a toll on him and advanced his dementia. It is very sad that they can fix their bodies but it is at the expense of their brains.
Daddy was in hospice for only a month or so. And that long only because he refused to die during the holidays. We fed him popsicles and sips of Gatorade, he threw up pretty much everything else. My brother is an EMT and "snuck" my dad a couple of bags of IV fluids so he could have his wish of not dying during Christmas. He was on round the clock morphine and topical Valium so he could stay calm. He died 45 minutes into New Year's day. We don't consider that a holiday! His death was a beautiful release. I think, depending on your belief system, hospice and the inevitable outcome can be beautiful and sweet. THANK GOODNESS for Hospice care. It helps you to know you are keeping your loved ones comfortable to the end. Runner---hang in there. Your plate is so full. (If your parents are not aware they aren't in the same place--moving your dad sounds really tricky--leave it be. Harder on you, but maybe better unless he improves a lot.)
Many here have given you good advice. My only addition would be to be aware that Hospice is not the same everywhere. You need to explore Hospice and pallative care, if available, in your area and evaluate/compare which program, if either, would be of most benefit to your father and you. For instance, in my area Hospice personnel are all voluntary and can not, do to lack of adequate staffing, provide 24/7 care. Here, it is offered in our hospital..in-patient hopice care. They can only do 1-hour check-ups in the home. Hospice has a limited role, but still in charge, and you have to follow their rules. There are rules to follow once you agree to Hospice care. You may not agree with these rules, especially when it comes to your father's lack of eating.
Hospice will/should meet with you before any agreement, to explain how it works.
I wish you and your family the best. May peace come to your family.