Does anyone have any thoughts or suggestions about revoking hospice when a loved one’s health improves? My mom is 88 years old and went into home hospice about three months ago. She had been in an SNF for rehab after receiving a spinal fracture in a fall, but her condition declined to where she was in constant pain, unable to participate in rehab, eating very little, and not cognitively aware of the situation. When she was discharged to home hospice, the nurse thought that she might only survive another month or so. They discontinued most of her medications, including her blood thinner and Type 2 diabetes pills, and provided comfort medications that she is using sparingly at this point. Now that her fracture has healed, she is doing so much better. She is eating again, mostly pain-free, getting stronger, and is cognitively much better (she has mild dementia). She has not walked more than a few steps since the fall but she is able to stand and assist with transfers. I think that she could regain some mobility with physical therapy, but that doesn’t seem to be an option if she stays on hospice. She will be a fall risk, but would like to be able to get around with a walker. I also wonder if she should be restarting her diabetes medicine now that she’s eating again and starting to put some weight back on. I have asked the hospice nurse, but I’m not getting a clear response. Should we stick with hospice and see how she does, or take her off it in order to get PT and resume her regular medicine?
My mom was on hospice for 18 long months while she was in a SNF. Was completely bedfast. Like twice she started perking up, big time… like making meal requests, hitting the call button to be taken to toilet and to shower, asking to be put in her geri chair to use the telephone at the nurses station. The hospice coordinators called to let me know, mom was going to get a full on assessment for their EOM report to Medicare. She had a lil TIA transient ischemic attack right b4 the evaluation so hospice continued. I was beyond surprised that for a completely bedfast patient this could even be considered something to do, but it can be.
The only way one can continue to remain under hospice care is if the patient continues to decline, so if mom keeps improving, they will eventually stop their services.
Ultimately this decision is up to your mother.
As in "Mom do you still want to go to doctors and hospitals and treat all these things that will prey on you now as you age, or should be keep you safe and comfortable knowing that we are all headed the same place. You are in hospice care now and they won't have you go to hospital for treatments. Is that what you want? Or do you want to go to doctors and hospitals again".
If she has the cognition still to make that decision she makes it. If she doesn't, you are the one who knows her best, and you make it as next of kin or POA --or that person makes it for her.
I know what I would want were you my daughter, and you would know as well, just as my daughter does.
Good luck. This is tough stuff. But that spine isn't going to correct itself again.This isn't going to get a whole lot better. IMHO as a retired old nurse of 82.