My mother is currently in post acute care due to falling several times at the memory care facility. She has declined rapidly in the past few months. It has been suggested to call in hospice when she returns to MC for "extra care". My family has mixed opinions about this because, in their minds, hospice means taking mom off all her meds and medical care, not eating, not drinking, and making her comfortable with sedation until she passes. Can our family make the decisions about what care mom receives during hospice? Can we make the decisions about meds, hydration, food, and sedation?
The things your family has described will happen later when his body starts shutting down. There are clear signs when that happens and he is in end-of-life. When his organs no longer work he’ll be in pain, and that’s why they stop feeding food that he can no longer digest or giving liquids that his body can no longer process. He’ll get morphine and sedation, which will make his inevitable passing peaceful.
Please educate yourself and family about hospice. They will be glad to meet with you and family to explain the whole process. They are there to sustain life as long as possible and to make the end of life peaceful and tranquil. They are not there to torture your loved one or cause her harm in any way. Her POA will be involved as much as he/she wishes and can have input as to her care. Also mom can be removed from hospice at any time if that’s what POA wants to do.
They will stop medications and medical care which are intended to keep the patient healthy and prolong life. They will continue medications which treat medical conditions if it adds to the comfort of the patient.
For instance, my husband was recently on hospice, and discharged from hospice because he is currently stable; hospice will discontinue medications to treat high blood pressure and to treat plaque build-up in the arteries, and glucose control medications. However, they provided his Prilosec (for acid reflux) because it keeps him more comfortable. He also had a wound care nurse and some medicated creams prescribed to treat a nasty infection on his toe, which was scabby and bloody.
I was told I could give him any medication I want, but they would not provide anything outside of their comfort care plan.
Something to keep in mind; often near end of life, people will stop eating and drinking, they may even fall into a non-responsive state. This is all a natural part of the process, as the body starts to shut down. So, if she stops eating, or it becomes unsafe for her to try and eat, hospice may support not giving food.
In the case of my grandmother. She was on all the same meds she was on before for high blood pressure and cholesterol. They didn't stop any. In fact, they were pretty on the ball to make sure we kept getting the refills. She was on hospice for about a year. They just made available other meds. Those being pain meds like liquid morphine. They also provided supplies like diapers, wipes, pads, etc. since she was on home hospice. In MC, your mother should already be getting those.
IMO, the big reason for hospice was of course to deal with discomfort at the end, that didn't end up being necessary. But also to avoid the whole someone died at home thing involving the cops, the corner and everything else. In the end, everyone showed up with lights flashing anyways including the cops and the paramedics but at least the coroner didn't come since she was on hospice and the hospice people were able to declare the death.
My late husband was under hospice care in our home for the last 22 months of his life and he remained on all of his prior medications until shortly before his death when he was unconscious.
And if any medical care is required like treating a UTI hospice will treat that as well.
And yes the family makes the decision about everything that hospice does. They do not remove any foods or drinks. Your loved one when they start the actual dying process will automatically stop wanting food or drink as their body starts to shut down.
Hospice is there to help not hurt, and to make the dying process easier for all involved.