Does he have a death rattle? If he does, that is not good. Sign of impending death and hospitals generally don't interfere.

They need education about the difference between hospice and palliative care.

I think other PPs are correct that you need to support your DH. But I hope they talk to palliative care about figuring out if there is a way to get him home. Best case, he snaps out of his delerium and lives a while longer. Worst case, at least he dies at home but it is not clear that being in the hospital is helping. Remember, hospice care is for people who are expected to live for 6 months or less, but that doesn't mean they all actually live for 6 months or less. it just means that the hospice team is going to focus on quality of life vs prolonging his life.

Is dialysis temporary or permanent? If permanent, who's going to take care of 3/week dialysis sessions in addition to the delirium? If MIL is all tapped out, emotionally, physically and $, does the family (DH + sibs) have resources to support outside help?

Support DH now as he needs time to digest the latest twist, but suggest a reasonable time frame (1mo, 3mo, etc) to revisit the hospice issue if FIL doesn't get better.

I’d be a good listener for my husband and other than suggesting getting a second opinion I’d stay out of it. I would find out if your FIL has a living will which might indicate what his wishes are given the condition he is in. When my father was dying my DH simply asked what he could do to help me and left it up to my siblings and me to manage the end of life process.

Anonymous wrote:OP - it's up to the patient's spouse. That's it, that's all. That is who makes the decision. That is who has the legal power to make the decision. That is the only one with the legal power to make the decision.

Yes. Your H and his siblings must not lose sight of this. They need to support their mom and help her reach a decision that's best for her.

Also, a person can enter hospice care and leave it later. Hospice just means no active treatment for whatever underlying condition, but they'll make him comfortable and provide respite for your MIL.

Maybe have conversations with dH about what his father would want.