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My mother has had Afib for more than 5 years. She is now 103. Early this year she had a UTI and I thought it was curtains until I found out the culprit. It's an easy cure. My mother is back working in her garden and enjoying her cat. Don't give up on your loved one over a UTI. Hospice means ready to die. No preventative care, and only keeping them comfortable until they die. UtI does make them act crazy, but it's reversable almost immediately upon taking the antibiotics..
My mother has mild cognitive impairment (beginning of Alzheimer's). Her health is really frail (heart, diabetes, kidneys, COPD, and other issues and take 13/15 pills x day to control those issues.). She's gone through the FIB and UTI conditions and she is still managing well with meds treatment and caring. What makes you think your mother is ready for hospice care? Hospice is for the short term terminally ill. It doesn't seem to me yours is there yet. It sounds you are not well informed, are rushing and getting all uptight and nervous about the unknown future. Getting informed and learning as much as you can ahead of time about what steps are actually needed to take as your mom's age and health issues progress is the best approach. Know that it's not a clean-cup process. It's a step by step as things change. You need to look at it day by day, and not get overwhelmed. Just saying and trying to help here...
If your using a nursing agency, the case will have to be closed & reopened with the physicians order. Is "Mom" near death? She is in need of Hospice??? I believe, being an R.N., that it is done by someone in social services or home health care; they would approach you if hospice was indicated. Physicians order is required.
A fib can cause strokes which greatly impair quality of life; but if you want to use only whatever oral meds there are to safely anti-coagulate and control heart rate to avoid any heart symptoms, rather than put her through cardioversion or a cath or anything more invasive, that would be reasonable. Likewise, you might treat UTIs with oral antibiotics but if IV antibiotics are too burdensome, don't do that. Stopping long-term preventive type meds that are having side effects may make sense too.
You can attend to quality of life first and foremost with or without going on hospice.
I probably should put this on the Kevorkian post - I ethically favor the position of not removing ordinary care and absolutely not hastening death by any primary deliberate means, but consider it very permissible to omit burdensome care that limits quality of life with the intent of prolonging it. Some people do better without some interventions - in some studies, patients switched to hospice or comfort care live longer than those doing "everything possible."
If you are feeling frustration and burnout that can be very, very normal. Do your best to hang in and try to make thoughtful choices rather than all-or-nothing ones, in consultation with Mom's caregivers. That way if any good memories can still be made and positive experiences can still be had, you and Mom can have them, and in the end when it is over - could be a while, could be soon - you have no regrets.
Mom has to WANT Hospice. It's not up to us, it's up to Mom and her MD. You siblings need to sit down and come to agreement on things, because you are burned out.
The mental effects from a UTI can mask dementia, or make already existing dementia worse. Afib is entirely manageable with medications. Neither condition is terminal, & hospice is for terminal conditions like cancer or ALS & end-of-life comfort care. I don't know why you'd want to "stop services". More information is needed.
I agree with the previous posters . I'm a RN ( wish I got big bucks ) and also my moms caregiver . Remember if you sign AMA your insurance may refuse to cover your bill and you will need to pay out of pocket .if she has a UTI and a fib ( I think new onset ) she will need to be on a blood thinner which will need to monitored very closely with labs . A UTI is manageable as long as it is almost gone , seniors can get confused and it can back up into their kidneys . I think to have a safe discharge you need to follow closely with the Drs . See what meds your mom is on , what blood thinners she is on and how to manage them. Have then get another urine culture , what does her EKG look like ? Is she walking on her own? Does she have Physical therapy and occupational therapy working with her . When seniors stay in bed they get weak .. Please make sure she is a safe discharge home ,
One can always leave a hospital "AMA" (against medical advice). Remember their job is to get you healthy, but in doing so they are getting paid big bucks to keep you there. If your mother can be managed at home, her heart and kidneys can be treated with meds. What makes you think she is ready for hospice? What does her doctor say? Don't count her dead yet. She probably has a few years remaining.
A fib and UTI are not normally fatal. Treating them is not about longevity but about quality of life, at least as I understand it.
What stage of the dementia is your mother at? Is she competent to make her own medical decisions? Do you have medical power of attorney to make decisions on her behalf?
To go on hospice requires a doctor's approval. Have you discussed it with her doctor? It would not hurt to have an evaluation for that, and if it is determined that Mother is not eligible for that at this time you will be ready to reconsider when the time comes.
Unless she really is in the last 6 months of her life, I think I would want her treated to improve her comfort level. A UTI can make the dementia symptoms much worse and/or add new dementia-like symptoms, and that will go back to her former baseline when the UTI is treated.
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.
Is "Mom" near death?
She is in need of Hospice??? I believe, being an R.N., that it is done by someone in social services or home health care; they would approach you if hospice was indicated. Physicians order is required.
You can attend to quality of life first and foremost with or without going on hospice.
I probably should put this on the Kevorkian post - I ethically favor the position of not removing ordinary care and absolutely not hastening death by any primary deliberate means, but consider it very permissible to omit burdensome care that limits quality of life with the intent of prolonging it. Some people do better without some interventions - in some studies, patients switched to hospice or comfort care live longer than those doing "everything possible."
If you are feeling frustration and burnout that can be very, very normal. Do your best to hang in and try to make thoughtful choices rather than all-or-nothing ones, in consultation with Mom's caregivers. That way if any good memories can still be made and positive experiences can still be had, you and Mom can have them, and in the end when it is over - could be a while, could be soon - you have no regrets.
Both A Fib and UTIs are successfully treated and do not necessitate hospice care.
Hospice care is for the dying.
What stage of the dementia is your mother at? Is she competent to make her own medical decisions? Do you have medical power of attorney to make decisions on her behalf?
To go on hospice requires a doctor's approval. Have you discussed it with her doctor? It would not hurt to have an evaluation for that, and if it is determined that Mother is not eligible for that at this time you will be ready to reconsider when the time comes.
Unless she really is in the last 6 months of her life, I think I would want her treated to improve her comfort level. A UTI can make the dementia symptoms much worse and/or add new dementia-like symptoms, and that will go back to her former baseline when the UTI is treated.