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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.
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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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I'm more familiar with hospice care than palliative care - but palliative care is designed to keep the patient comfortable when not pursuing active treatment of disease. I believe this can be utilized when the patient doesn't meet guidelines for hospice - death not expected to occur within 6 mos.
Hospice care is end of life care and is similar to palliative care in that no active treatment of the disease is treated but the patient is kept comfortable and allows them to meet death with dignity.
My father was on hospice the last six months of his life and the agency we used was very caring of both my father and the family. At 91 dad landed in the hospital with what was thought to be an upper respiratory virus going around that mom had had. However he was Dx with CHF, Afib, leaky heart valve and another heart issue - he had already been dealing with AD and vascular dementia. He was done no more rehab no more treatment. As far as I know dad was never in physical pain and the pain meds were never used but he was taken off all meds except those that kept him comfortable - like the drugs to keep fluid from building up.
So the question, is mom looking to stop active treatment of her heart disease, if so then you should speak with her, your siblings and her docs about options.
Hope this helps - also check out the care topics at this website for more information on palliative and hospice care. Good luck.
I was surprised to learn that now palliative care differs from hospice in that palliative care—keeping someone comfortable—is done while receiving treatment, whereas hospice is for people with a terminal condition. Those terms used to be almost interchangeable. I learned about this while trying to figure out care for my brother with glioblastoma.
Ask your moms cardiologist. I asked my moms about a year before she died and he transferred her to a group that helped me manage her CHF more intimately. I had a doctor/nurse who were immediately available. I was already working with a great HH Agency that was also very responsive. I wish I had asked again but she actually passed from aspiration pneumonia. I would have spared her the last hospitalization if I had asked. With my DH aunt, when she became incontinent, I asked for more baths from the HH. They explained she could get those through Hospice. She qualified because of her dementia. So, ask your moms doctor or call a hospice and discuss. If she’s not eligible now, you will learn a bit more about when she would be. It’s been a good move for aunt and me. She was already on homebound home health so it wasn’t a huge change, just more help. Plus some of her expenses are covered which allows more funds for extra hours for her aide. And it’s good to have them onboard before she goes into a deep decline. I hope this helps.
I agree with other postings that say to check with her doctor. They will guide you in the right direction.
I seriously doubt that you or your mom would even desire surgery at her age. Your profile says that she is 88. So, you can be satisfied with palliative care. If the situation worsens drastically, then by all means, utilize the services of hospice care. They will offer comfort care, a social worker and clergy.
Thanks for the advice. One reason I asked is that my dad passed the night before I was going to ask for hospice care to help out my sister (they took in him to her house for 4 months). I was also concerned with her quality of life. Mom can barely stand and pivot to get on her commode. My sister lives nearby and has been great with assistance (just as I did for her when she had my dad). I live alone with her in my house, and am worried about burning out myself. Surgery is not an option at this point.
Most people believe that calling in Hospice means their loved one is near death. What it actually means is the acknowledgement that your loved one is not going to get well or even better. They provide so many other things than just medical care. They have Chaplains, nurses, counselors. They will spend time with the family as well as with your loved one.
Aim high...Shoot for the stars! Far to often people wait and are not able to take advantage of all that Hospice has to offer. If mom is eligible for Hospice you will get far more in the way of help, supplies, equipment than if she is on Palliative care. However if you feel that Hospice is not quite what you want yet (for some it is a bit daunting making that decision) Palliative is a nice first step. The Palliative Care team will let you know when they think it is time for Hospice. But, me being me, I would try for Hospice first if I thin found out she was not eligible I would go with Palliative. Contact a few Hospice in your area. Interview them. Let them tell you if mom is eligible for Hospice. Select the one you have a good feeling about, one that you have checked reviews on. They all have Social Media presence check that out. Once you have selected you are not bound to them, you have the right to change Hospice just like you can change to another doctor if you feel you are not getting the care you want or deserve.
Hospice Care is usually if a patient will be dying within 6 months and not seeking any treatments just being treated with Comfort Care like pain management.
Palliative Care is Comfort Care along with continued Treatments.
Your Dr will advise you when they think the patient should go in to Hospice Care but at that time, start with Palliative Care.
We just included a palliative care dr to my mom’s team. Super helpful in coordinating care among her specialists. He has already been a great advocate in identifying and addressing her needs. We have a clear plan of her priorities and cater to that. My mom is not at end stage so don’t be afraid to explore that option before you get to that point!
Do an intake interview with hospice. They will advise on available services and you will be prepared to start their services when needed. Friends and family repeatedly suggested for two years that we do this, but we were reluctant. I finally called on a Monday afternoon, the interview was conducted Tuesday morning and hospice was ready when needed later that same day. My friend passed away that evening just a few hours afterwards. Hospice came to certify the death so we avoided transporting a body via ambulance to the nearest hospital so they could confirm the obvious. They also called the funeral home to pick up the body. I have no doubt that hospice would have been a tremendous ally had events happened more slowly.
Bless your heart! I know this is all very difficult, we all have to be ready for this eventuality.
To keep it short, my mother is 89 years old, has multipal medical conditions that require medication, and has 24 hour supervision. She is in constant pain from her arthritis and a compression fracture in her spine. She can get out of bed with her walker but has still fallen. Her mental capacity is mid to late stage dementia.
I asked the Board and care manager if there was anything else I could do for her and was told to ask her PCP about Palliative Care. I had never heard of it before, so she had to explain it to me. When I asked her doctor about it he put in an order for her evaluation right then.
The person they sent out was very patient and kind to mother. She asked me alot of questions but also asked mother separately. It was dicided that she did not need it at this time, but they would be happy to re-evaluate her again if her situation changes.
It doesn't hurt to ask and it can relieve/confirm your concerns.
Good luck with all of this. Hang in there, you are not alone.
I thought someone with significant medical issues could include Palliative Care any time during the course of their illness. It seems worth investigating the Palliative Care options in your area.
im not directly answering the question you asked, but you mentioned in a post that your mom is having difficulty with transferring to commode. You can ask her doctor for physical or occupational therapy for her. (At least for now) They came out to our house when my mom lived here, they evaluated her needs, did exercises with her to gain strength/mobility and gave her exercises to do. And came a few times/week for several weeks. It was helpful. Mom loved the attention , too.
My mom was on hospice 9 months. She had asked for years not to be taken to the hospital, or to be resuscitated. She got to the point she didn't even want physical therapy, and would certainly not have wanted chemotherapy for cancer. Hospice doesn't take away all treatment. My mom continued the medicine to try to prevent strokes, and I knew that if she had an infection or illness that she would have been given antibiotics. Some the best things about being on hospice were the weekly visits by the nurse, the doctor a phone call away, home visits by a nurse instead of an exhausting trip to the emergency room, and the portable x-ray machine when she broke her arm. As her condition changed, they could change her medicines and treatment plans within about 12 hours with home delivery of prescriptions. I really felt like her health was more stable on hospice, than when we had to call the doctor's office and schedule an appointment a week later.
I totally agree! I’ve felt they’ve been more connected to him and his care, as well as with me an my niece. All of which has given us more peace of mind.
When it came to deciding whether to place my brother, 65, in hospice, my guiding idea was comfort. In a period of less than six months we went from thinking he had early onset dementia to being diagnosed with glioblastoma. The tumor covered almost half his brain—the first surgery was for biopsies and the second was to remove as much as possible. He had already lost his ability to remember, solve problems, look after himself, exercise good judgment, etc. He was worse after the second surgery and too many events afterwards lost time for the best opportunity for radiation and chemo. He refused meds and heparin shots. So treatment was going to be futile.
Placing him in hospice was one of the hardest decisions I’ve ever had to make and I consulted with a cousin who’s a surgeon as well as the Brain Tumor Network. His doctors were frustrating—they just kept pushing for treatment. I discussed this decision with my 22year old niece who is daddy’s girl and she was in agreement. Using the Medicare website I found the best hospice and a much better nursing home. He’s improved a lot since being in hospice. He has lots more attention and has been far more cooperative and walking better.
One of the hospice people invited a guitarist friend of hers to play for my brother who was a rock guitarist. My niece brought her dad’s guitar. The hospice people were amazed at how much he opened up. He tapped his hand in rhythm, was smiling, laughing and talking. Generally he’s had a flat affect. I know there’s no way he could have enjoyed this time had he been getting treatment. The musician friend is coming again next week. We’ve found he is so much more cooperative with music. He kept resisting taking a shower, but when the hospice nurse played Arrowsmith on her phone he became agreeable and got in the shower. I’m getting Alexa for my niece and her boyfriend to program playlists for him since he’s unable to use devices. I know the good moments won’t last but we’re making good last memories.
Hospice is most often seen as THE END since that’s typically when patients are brought in. Sometimes I think doctors see putting patients in hospice as failure that they couldn’t cure them. The hospice people tell me the purpose is to make the most of remaining life, and comfortable as possible as life ends. I am so glad he’s in hospice instead of misery from treatment.
Two books that were immensely helpful in decision making were “Being Mortal” by Atul Gawande, (a surgeon) and “Farewell; vital end of life questions with candid answers, by Edward T Creagan (medical oncologist and palliative care and hospice physician at Mayo Clinic). Survey after survey has shown people would rather die at home. Theres a growing awareness that treatment isn’t appropriate, that patients have the right idea.
Discuss with her PCP your options. Is she a candidate for Physical/Occupational therapy to help with her weaknesses? Does the doctor think that your mom is strong enough to handle PT or OT? What are your mom's wishes, does she have a DNR, or has she got something in writing that says she doesn't want to go to the hospital? Have the doctor have an assessment team come in and evaluate what is the best treatment plan for your mom. Best Wishes
My understanding is that palliative care comes before hospice care. I would talk to the palliative folks first and explain where your loved one is. They will help you determine whether palliative or hospice care is best.I have been told it is better to get hospice care early rather than waiting toward the end. I have gotten hospice for my Mom. She is not being treated for her lung cancer and that is why hospice is right for her. The upside is the nurses are wonderful and it provides a social outlet at a time when many of her friends have died and relatives do not visit. The downside is that it created some problems with insurance on her non-hospice care bills like foot care where they had to send it in over and over because hospice takes over and pays for hospice related care. You can also go off hospice if you decide you want treatment. My Mom may decide she wants to look into getting her cancer treated then we will have to go off hospice so it can be covered by her insurance. Wishing you all the best!
The difference between the two : Pallative Care vs. Hospice Care. Pallative Care is care that supports the needs of the family. They typically get less day to day care such as daily aides for cleansing, dressing, and feeding. A nurse will stop by to check on the patient and do temperature check, blood pressure checks, and heart/lung checks. They will offer advice and answers to those questions that keep you wake at night. On the flip side, Hospice Care is the one that gives you more day to day supports. The down side is that you must get accepted into the program. They look at the patient having 6 mos. or less to live. They will periodically reevaluate the patient in order to stay in the program. Services include aides, nurses, doctors, chaplins, equipment, social-workers, and medicine, ……etc…… Patients at this point tend to be more likely bed ridden and need a more advance medical guidance.
Pallative care - some costs are covered by Medicare and secondary insurance, some are not which then patient has to pay. Hospice care - just about all the costs are covered by Medicare (except room costs). For my mother that was a big consideration since she had limited funds.
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").
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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.
Hospice care is end of life care and is similar to palliative care in that no active treatment of the disease is treated but the patient is kept comfortable and allows them to meet death with dignity.
My father was on hospice the last six months of his life and the agency we used was very caring of both my father and the family. At 91 dad landed in the hospital with what was thought to be an upper respiratory virus going around that mom had had. However he was Dx with CHF, Afib, leaky heart valve and another heart issue - he had already been dealing with AD and vascular dementia. He was done no more rehab no more treatment. As far as I know dad was never in physical pain and the pain meds were never used but he was taken off all meds except those that kept him comfortable - like the drugs to keep fluid from building up.
So the question, is mom looking to stop active treatment of her heart disease, if so then you should speak with her, your siblings and her docs about options.
Hope this helps - also check out the care topics at this website for more information on palliative and hospice care. Good luck.
With my DH aunt, when she became incontinent, I asked for more baths from the HH. They explained she could get those through Hospice. She qualified because of her dementia.
So, ask your moms doctor or call a hospice and discuss. If she’s not eligible now, you will learn a bit more about when she would be. It’s been a good move for aunt and me. She was already on homebound home health so it wasn’t a huge change, just more help. Plus some of her expenses are covered which allows more funds for extra hours for her aide. And it’s good to have them onboard before she goes into a deep decline. I hope this helps.
I seriously doubt that you or your mom would even desire surgery at her age. Your profile says that she is 88. So, you can be satisfied with palliative care. If the situation worsens drastically, then by all means, utilize the services of hospice care. They will offer comfort care, a social worker and clergy.
Best wishes to you and your mom.
Far to often people wait and are not able to take advantage of all that Hospice has to offer.
If mom is eligible for Hospice you will get far more in the way of help, supplies, equipment than if she is on Palliative care. However if you feel that Hospice is not quite what you want yet (for some it is a bit daunting making that decision) Palliative is a nice first step. The Palliative Care team will let you know when they think it is time for Hospice.
But, me being me, I would try for Hospice first if I thin found out she was not eligible I would go with Palliative.
Contact a few Hospice in your area. Interview them. Let them tell you if mom is eligible for Hospice. Select the one you have a good feeling about, one that you have checked reviews on. They all have Social Media presence check that out. Once you have selected you are not bound to them, you have the right to change Hospice just like you can change to another doctor if you feel you are not getting the care you want or deserve.
You need to talk to her doctor and it requires a doctor's order.
Palliative Care is Comfort Care along with continued Treatments.
Your Dr will advise you when they think the patient should go in to Hospice Care but at that time, start with Palliative Care.
I know this is all very difficult, we all have to be ready for this eventuality.
To keep it short, my mother is 89 years old, has multipal medical conditions that require medication, and has 24 hour supervision. She is in constant pain from her arthritis and a compression fracture in her spine. She can get out of bed with her walker but has still fallen. Her mental capacity is mid to late stage dementia.
I asked the Board and care manager if there was anything else I could do for her and was told to ask her PCP about Palliative Care. I had never heard of it before, so she had to explain it to me. When I asked her doctor about it he put in an order for her evaluation right then.
The person they sent out was very patient and kind to mother. She asked me alot of questions but also asked mother separately. It was dicided that she did not need it at this time, but they would be happy to re-evaluate her again if her situation changes.
It doesn't hurt to ask and it can relieve/confirm your concerns.
Good luck with all of this. Hang in there, you are not alone.
Hospice doesn't take away all treatment. My mom continued the medicine to try to prevent strokes, and I knew that if she had an infection or illness that she would have been given antibiotics.
Some the best things about being on hospice were the weekly visits by the nurse, the doctor a phone call away, home visits by a nurse instead of an exhausting trip to the emergency room, and the portable x-ray machine when she broke her arm. As her condition changed, they could change her medicines and treatment plans within about 12 hours with home delivery of prescriptions. I really felt like her health was more stable on hospice, than when we had to call the doctor's office and schedule an appointment a week later.
Placing him in hospice was one of the hardest decisions I’ve ever had to make and I consulted with a cousin who’s a surgeon as well as the Brain Tumor Network. His doctors were frustrating—they just kept pushing for treatment. I discussed this decision with my 22year old niece who is daddy’s girl and she was in agreement. Using the Medicare website I found the best hospice and a much better nursing home. He’s improved a lot since being in hospice. He has lots more attention and has been far more cooperative and walking better.
One of the hospice people invited a guitarist friend of hers to play for my brother who was a rock guitarist. My niece brought her dad’s guitar. The hospice people were amazed at how much he opened up. He tapped his hand in rhythm, was smiling, laughing and talking. Generally he’s had a flat affect. I know there’s no way he could have enjoyed this time had he been getting treatment. The musician friend is coming again next week. We’ve found he is so much more cooperative with music. He kept resisting taking a shower, but when the hospice nurse played Arrowsmith on her phone he became agreeable and got in the shower. I’m getting Alexa for my niece and her boyfriend to program playlists for him since he’s unable to use devices. I know the good moments won’t last but we’re making good last memories.
Hospice is most often seen as THE END since that’s typically when patients are brought in. Sometimes I think doctors see putting patients in hospice as failure that they couldn’t cure them. The hospice people tell me the purpose is to make the most of remaining life, and comfortable as possible as life ends. I am so glad he’s in hospice instead of misery from treatment.
Two books that were immensely helpful in decision making were “Being Mortal” by Atul Gawande, (a surgeon) and “Farewell; vital end of life questions with candid answers, by Edward T Creagan (medical oncologist and palliative care and hospice physician at Mayo Clinic). Survey after survey has shown people would rather die at home. Theres a growing awareness that treatment isn’t appropriate, that patients have the right idea.
Is she a candidate for Physical/Occupational therapy to help with her weaknesses? Does the doctor think that your mom is strong enough to handle PT or OT?
What are your mom's wishes, does she have a DNR, or has she got something in writing that says she doesn't want to go to the hospital?
Have the doctor have an assessment team come in and evaluate what is the best treatment plan for your mom.
Best Wishes
On the flip side, Hospice Care is the one that gives you more day to day supports. The down side is that you must get accepted into the program. They look at the patient having 6 mos. or less to live. They will periodically reevaluate the patient in order to stay in the program. Services include aides, nurses, doctors, chaplins, equipment, social-workers, and medicine, ……etc……
Patients at this point tend to be more likely bed ridden and need a more advance medical guidance.