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Who are you caring for?
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?
Acknowledgment of Disclosures and Authorization
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.
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Mostly Independent
Your loved one may not require home care or assisted living services at this time. However, continue to monitor their condition for changes and consider occasional in-home care services for help as needed.
Remember, this assessment is not a substitute for professional advice.
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Hospice is end of life. Usually, its determined the person will not last 6 months. Not that it can't be longer. One members husband was on Hospice for two years. Be aware, the caregiver will still be doing all the work. Hospice is confort care. A nurse comes out once a week. An aid maybe 3x a week to bath the person. You may be able to get more than an hour so the caregiver can run errands or just time to themselves. Morphine will be supplied for the pain, and the caregiver will be given instructions on how to administer it. A hospital bed will be given. Incontinent supplies provide as will the comfort meds at no charge. And as said, no more hospital or doctor visits.
For some on this forum, Hospice was a God send. For others an intrusion in their lives. Me, Mom was in LTC so I did not need to deal with Hospice.
With Hospice there would be fewer if any visits to the ER. (Hospice can authorize hospitalization if it is necessary) There would be no further treatments for a condition that would make them eligible for Hospice. There would be closer monitoring of health status (A nurse would come at least 1 time a week to check vitals and order any medications. Medications will be delivered to them) A CNA would come at least 2 times a week and give a shower or bath and order any personal supplies that are needed. They also will be delivered. Any equipment that is needed to safely care for them would be ordered by the Nurse and that also would be delivered. You could request a Volunteer that can come and either visit or if needed light household chores. I am of the firm belief that it is never to soon to ask for a Hospice evaluation.
In the book “Being Mortal:Medicine and What Matters in the End: Atul Gawande discusses having talks with loved ones.
These to help them discern where they are in life and what their condition is. Then to help them understand what is most important to them…what would make it worthwhile to them to keep living.
There are several questions to open the dialogue and he has said that often we have to have these discussions more than once. We don’t always know the answers and we change our minds or refine our answers. I heard him recently on a podcast with Dan Harris discussing how he negotiated these things with his own parents. He had a lot of nice things to say about an RN who was explaining the benefits of palliative care and who helped him develop those questions for medical staff. He was 44 when he wrote that book and is 60 now and has lost both parents.
Why do you feel your loved one is ready for hospice? They may qualify for homebound home health services through Original Medicare which can really reduce the need for office visits. Find an agency that also has a hospice and they will suggest hospice when they see she qualifies and it is an appropriate next step.
My LO was incontinent x 2 and I chose Hospice for more baths. She qualified but extra cna visits were the only thing that i was trying to add. She was already on home health and had daily help. There wasn’t much difference at that point between the two services. She also had a geriatrician who stayed with us through the end even though she was in a facility the last three years. We weren’t ever doing ERs etc. other than two on the same weekend one time. One local and one 2 hrs away. That’s when I found the geriatrician and primarily used Telemed after initial visits. This before, through and post covid. Before and all through hospice. Let me be sure to add that not all services are the same in each area. Just telling you what I did.
Here is a link to that podcast. You can find a lot on Dr Gawande online.
Heck, I am a functioning person in my 70s. If my daughter asked me about my feelings, I can have a conversation. Maybe just sit down and staraight out ask her. Can we have a conversation about your health and how far you want to go with treatment? There used to be a website on these conversatiions. Maybe someone remembers the _________project.com
How does this person feel about going to the ER for the required 4 hour minimum each time and getting no real help or answers? If this person is tired of that rigamarole, Hospice may sound like a great alternative.
In my family’s situation, dad’s doctor mentioned it first. From there a referral to a hospice agency was made. An amazingly knowledgeable hospice nurse came, had a private conversation with dad, with no one else included, answered all his questions and concerns, and filled him in completely on what choosing hospice would look like. Family members never had to approach him at all, or handle any discussion about it. My dad was functional, but had a steady decline due to congestive heart failure.
Can you tell us more about the situation? (1) Are you concerned about the discussion with the person who would be receiving hospice care or with a hospice provider? (2) Does the person who would be receiving hospice care have a diagnosis? (3) Is the person who would be receiving care being treated for any conditions? (4) Are you generally privy to the person's health-care information, are you helping the person make decisions, or both? My mom received hospice care starting around age 95; she had dementia, congestive heart failure, and various infirmities of aging. My sister did not want us to use the word "hospice" when talking about the possibility with mom. I don't recall whether that word was used. The transition to hospice care was recommended by the palliative care nurses, and they did much of the talking during the discussions with mom about it. I think it's probably easier to convince an individual to receive hospice care if a physician or nurse with whom the individual has a good relationship agrees and helps in the conversations.
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.
start the conversation with the doctor and anyone else involved along with the LO, if LO is still cognitive..
nothing is perfect, especially when it comes to end of life and the steps that are taken..
try to make your LO comfortable, and happy.
🙏
For some on this forum, Hospice was a God send. For others an intrusion in their lives. Me, Mom was in LTC so I did not need to deal with Hospice.
There would be no further treatments for a condition that would make them eligible for Hospice.
There would be closer monitoring of health status (A nurse would come at least 1 time a week to check vitals and order any medications. Medications will be delivered to them)
A CNA would come at least 2 times a week and give a shower or bath and order any personal supplies that are needed. They also will be delivered.
Any equipment that is needed to safely care for them would be ordered by the Nurse and that also would be delivered.
You could request a Volunteer that can come and either visit or if needed light household chores.
I am of the firm belief that it is never to soon to ask for a Hospice evaluation.
These to help them discern where they are in life and what their condition is. Then to help them understand what is most important to them…what would make it worthwhile to them to keep living.
There are several questions to open the dialogue and he has said that often we have to have these discussions more than once. We don’t always know the answers and we change our minds or refine our answers. I heard him recently on a podcast with Dan Harris discussing how he negotiated these things with his own parents. He had a lot of nice things to say about an RN who was explaining the benefits of palliative care and who helped him develop those questions for medical staff. He was 44 when he wrote that book and is 60 now and has lost both parents.
Why do you feel your loved one is ready for hospice? They may qualify for homebound home health services through Original Medicare which can really reduce the need for office visits. Find an agency that also has a hospice and they will suggest hospice when they see she qualifies and it is an appropriate next step.
My LO was incontinent x 2 and I chose Hospice for more baths. She qualified but extra cna visits were the only thing that i was trying to add. She was already on home health and had daily help. There wasn’t much difference at that point between the two services. She also had a geriatrician who stayed with us through the end even though she was in a facility the last three years. We weren’t ever doing ERs etc. other than two on the same weekend one time. One local and one 2 hrs away. That’s when I found the geriatrician and primarily used Telemed after initial visits. This before, through and post covid. Before and all through hospice.
Let me be sure to add that not all services are the same in each area. Just telling you what I did.
Here is a link to that podcast. You can find a lot on Dr Gawande online.
https://podcasts.apple.com/us/podcast/10-happier-with-dan-harris/id1087147821?i=1000788743539
(1) Are you concerned about the discussion with the person who would be receiving hospice care or with a hospice provider?
(2) Does the person who would be receiving hospice care have a diagnosis?
(3) Is the person who would be receiving care being treated for any conditions?
(4) Are you generally privy to the person's health-care information, are you helping the person make decisions, or both?
My mom received hospice care starting around age 95; she had dementia, congestive heart failure, and various infirmities of aging. My sister did not want us to use the word "hospice" when talking about the possibility with mom. I don't recall whether that word was used. The transition to hospice care was recommended by the palliative care nurses, and they did much of the talking during the discussions with mom about it. I think it's probably easier to convince an individual to receive hospice care if a physician or nurse with whom the individual has a good relationship agrees and helps in the conversations.