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I'm beyond frustrated through this process.


Background. Mom has pulmonary fibrosis and she in end stages of disease. Earlier this month hospitalized with UTI. Plan was discharge w hospice. I thought I did my due diligence, asked my friends who been through this for recommendations and then followed with questions. One of my must haves are Spanish speaking Nurses for my mom. I specifically stated Spanish speaking Rn, Lvn and bath nurse. Surprisingly many hospices didn't have Spanish speaking RN. Ok.


1st hospice I chose ended up being very pushy, even though I already told them they have our business. I fired them after they continued to be pushy after warning them. 2nd hospice said they had Spanish RN. Came time to set up admissions to hospice, no Spanish RN, so I fired them. My moms UTI came back and week later return trip to hospital. Hospital helped me with few more hospices, again vetted them and decided on company who said they had Spanish RN. I was very transparent with why I fired last 2 hospices. It's Thursday 4pm. Dr said my mom ready for discharge tomorrow morning, great! Hospice now tells me no Spanish RN available as she has full case load!!! Wtf?!?! I feel like these companies tell you what you want to hear so you sign up , put you between a rock n hard place.


In the meantime, I've had several people from social workers to doctors saying that I am not ready to face hospice and end of life care. Ok. Maybe that's why I fired 1st two. But again from the start, one of my must haves are Spanish speakers, so it is wrong of me to fire 3rd hospice who reassured me they had Spanish speaker and not able to deliver?! It's not whether I want hospice or not, but my mom definitely needs it. It scares me I have a hard time identifying another level of decline. A nurse who visits regularly could spot this better than I. But at the same time I refuse to be manipulated into something I don't want. Hospice and nursing homes seem to be predatory and thirsty for Medicare dollars.


Am am I the one who is being difficult and in denial?


How do I choose a hospice that I can trust that meets my needs? I'm in Southern California and surprised it's been hard to filled skilled RN that speak Spanish. My mom scheduled to discharge tomorrow morning.



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I hesitate to say this to someone who's as understandably stressed out and frustrated as you must be, but.

The Spanish language skills ARE proving a problem. I'm surprised, too. But since they are, and since the main reason you yourself state for needing hospice on board is the nursing skills, and specifically the ability to spot key clinical signs, then surely it would be better to prioritise those nursing skills and relegate the language skills to "nice to have" rather than "must have."

Experienced hospice nurses are practised in communicating with people who can't speak, can't hear, or even can't understand at all. It isn't that I think you're being intentionally difficult, or in denial, but I think perhaps you're not giving enough credit to skilled nurses' ability to care very well for patients they can't necessarily have a proper conversation with.
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A full case load? This is hospice. Did you ask when Spanish speaking nurse would have opening for another Spanish speaking patient? RN will be coming once a week for about a half hour? Would it be possible for you to be with her during that weekly visit? Or maybe a volunteer organization that could provide translation services? Perhaps a church would have members that look for a chance to volunteer in this way? Maybe you are not ready?

I googled Spanish speaking hospice southern California there were a number of hits. Have you talked with Bella Vida? Exclusive servicing Spanish speaking.

http://www.bellavidahospice.org/english/home.html
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If this is home hospice, I think someone has to be with Mom 24/7. Like said, home hospice the family does most of the care. RNs only show up once or twice a week to do vitals and evaluate. CNAs 2 or 3 times to bathe. You can ask for more time so u can do shopping or just get out of the house.

So like said, someone who speaks Spanish can be there for Mom. And I agree, that the CNA would be the one who needs to speak it.

I am from NJ. I too am surprised that they are short on Spanish speaking RNs. But then I was at Moms LTC and a woman was hollering in Spanish. One staff member came up to her speaking Spanish. She told me she was the only one on that shift that spoke it. Really?

There was an Italian lady who only spoke Italian. My RN daughter says when people have Dementia, they tend to go back to the language of their birth and forget their second language.
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busymom Jun 2019
Hey, JoAnn, you just taught me something about elderly with dementia reverting back to their “home” language. That makes perfect sense, however, I had never heard that.

So as your daughter has seen, we definitely need more nurses with the ability to speak various foreign languages. One would think that in California where “Mama2drama” has her mother, there would be multiple agencies filled with Spanish-speaking staff, but what we might think seems logical, may not be a reality.

I enjoy reading your answers on this site. You can tell that you’ve learned a few things in life.
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When my Husband was on Hospice the Nurse came 1 time a week but the CNA was here 2 to 3 times a week.
Since both the Nurse and the CNA schedule visits and the CNA will be the one that will work more closely with your Mom it might be better to "push" for a CNA that is fluent in Spanish. I am guessing you would be there for the visits with the Nurse so you could translate if necessary.
You are right about being surprised that there are few nurses that speak Spanish in your area. Unless they are finding employment in Hospitals if more lucrative for them.
Dealing with your Mom, her hospitalizations, decline as well as your health problems my guess is you are overwhelmed.
Ask again about getting a CNA that is fluent I think that will be more of a benefit than the Nurse simply due to the type of contact the CNA has and how much time she/he will spend.
By the way the term you used "Lvn" not sure what that is. I had a Nurse, the CNA that did personal care, bath, dressing him, ordering supplies, weight or measurements etc, then there was a Social Worker and a Chaplain.
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Shane1124 Jul 2019
LVN - Licensed Vocational Nurse - same a LPN ( I think).
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Make sure your mother is not being denied care due to inability to find Spanish speaking nurse, ok.
Let's face it. There are a number of factors here.
1. This is the United States where English is the primary language. 2. Spanish speaking workers are needed in every line of work in the country.
3. There is a major shortage of caregivers, nurses, CNA's, etc.

I would let the next company know you will fire them if they claim to have yet cant provide a Spanish speaking nurse. In all reality, you need to realize it just might not be possible.
Hire an Interpreter.
Best of luck and keep up the good work.
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We are not in California, and did not need Spanish speaking. However I must say that when we needed Hospice for my step dad we found a not-for-profit one that was MUCH better than the one that was affiliated with the NH. It also seemed to keep the staff "on their toes" better with his care since they were all used to the hospice people affiliated with the NH, and here was someone from the outside seeing what goes on.
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I find it hard to believe that hospices in SoCal have never had to accommodate people who spoke only Spanish. Maybe a hospice might be able to use a phone translation service. I’ve seen it used on TV but don’t know much about it. I hope you find what you want for your mother.
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anonymous902130 Sep 2019
I was shocked too. They have LVN nurses but not RN . Apparently the ones that are , are in high demand
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I dont have time to read all these responses, but if your mom is staying at home, then you may need hospice (try to find a non profit one) and you will also need home care service provided under medicare. And possible some added care to cover other times. Sounds like you are a candidate for assisted living.
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worriedinCali Jun 2019
Did you read the post? Not trying to be rude but your reply has nothing to do with the post. The OP does not need AL. Her mother is the person in need and her mother is on hospice. They having trouble getting a Spanish speaking RN through a hospice provider.
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I have also heard about people HAVEING BAD EXPERIENCES with Vitas and Yes I know they are for profit ...so are doctors ,and hospitals ,everyone who works are for profit so whats wrong with profit hospice I always wondered? They are doing Right by my Aunt and even prescribed antibiotics 3x for celluitis, UTI ,upper respitory infection ..she recovered from all 3 ailments and shes got a cna 2x per week RN 1X dr when needed hospice is for comfort at the end of their life if you need more help then a home health care agency may be better because they give you help about 12 hours a week or maybe even more but the home health is for profit too .
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I am so sorry you are going thru this. It also happened to me when my daughter was dying. I wanted the care that was appropriate and had questions to which I was told I was your 'typical grieving parent'. Now that I am trying to get some assistance - that is not even end of life care - for my 91 year old Dad, even our MDVIP doctor appears to be treating me the same way!!!! I, like you, just want the best for our parent. PLEASE DO NOT GIVE UP UNTIL YOU GET WHAT YOU NEED!! I can tell you from my experience with my Daughter....at the end you will know, and feel peace, that you did the very best for your loved one. God Bless You.
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