Reply to 95 year old mother falling repeatedly in assisted living

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[quote=Anonymous][quote=Anonymous]I'm one of the early PPs who pointed out to the OP that hospice isn't 24/7 and that it requires a prognosis of 6 months to live or less. I know from our experience trying to get hospice care for my father when his Alzheimers was very advanced (unable to walk, unable to self-care, unable to eat solid foods, etc.)

Dementia and/or old age alone will not qualify a patient for hospice. I forget the precise qualifiers but a google search will turn them up. One was a certain percentage of weight loss, another was being able to speak less than 6 words. My dad was rejected when we first investigated and then somehow qualified a few months later. He was in an excellent memory care facility, part of a much larger continuing care community, but the hospice services and personnel were a godsend. Unlike the nursing staff, their entire focus is on the patient's comfort. But as a visiting service, hospice doesn't fill the role of regular medical or nursing staff - they consult with the doctors and nurses and may take over some responsibilities like bathing on occasion, but visiting hospice isn't a substitute for nurses or nursing aides or doctors.

I don't have much direct experience with hospices houses, although I know that other relatives w/terminal diagnoses had excellent experiences in this setting. We investigated that for my dad, but it made no sense to move him from an environment in which he was well cared for.

Final point on the fall issue: as a rule, nighttime is a really really difficult for the elderly. Falling is a big problem, but so is wandering and sleeplessness. Other than paying for a 24/7 "sitter" it's a really tricky issue to solve - medication doesn't always work, it can compound the fall risk, restraints are illegal in many places because of the risks posed &/or ineffectiveness, etc.

The best advice I'd give someone with an elderly parent in poor condition is to speak with a palliative care specialist. Even if your parent isn't ready for hospice, they can help you think through what kind of care is best aligned with your parent's needs and preferences, and how to make sure the focus is on quality of life.[/quote]

It may depend on the hospice company and state.  For us, like you said dementia was not a qualifier but the weight loss was (until hospice came in and helped with the feeding and food issues and she gained weight) but lack of verbal communication was not a qualifier as people with dementia can go years without talking when its advanced.

If OP mom had a sprain or fracture or anything remotely justifiable for medicare she should apply as worst case she is turned down.  Given mom's age alone it may be a qualifier.  Best case, she gets help, even if its temporary to guide her through.[/quote]

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