When is it time for Hospice/ Palliative care Mom has AFIb, COPD, Severe Dysphagia, multiple rounds of aspiration pneumonia. 2 hospital stays and rehab within the last 6 months.
Mom is non compliant for Physical, Occupational, and Speech Therapy. Sees Geriatric Psych, Geriatrician. Has her PLOST form and DNR Orders. Has refused a feeding tube when suggested by her ST. Had an ankle break and refuses to do the therapy to get up and walk, or transfer. Due to these issues it’s hard to transport to Dr visits.
Incontinent of Bowel and Bladder. No diagnosis of Dementia or Alzheimer’s. Had her tested by Psych, and Neuropsychologist.
Recent CT scan checking to see if aspiration pneumonia resolved showed some changes to adrenal gland masses, recommended PET Scan. PCP has referred to oncologist.
All food is puréed and meds crushed due to the Severe Dysphagia. Potential silent aspiration on thin, thick, puréed, mechanical soft. ST says the safest is puréed but no guarantees.
you can frame POLST Form and have it over her bed or tape it on wall .
It certainly sounds like your mom is giving up. She has many health issues. She may not be able to do what is required to become stronger.
My mother in law died at age 68 with cancer. She fought hard at first, even went into remission for five years. When it came back, it did so with a vengeance. She made the decision to not to start treatment again.
She had non Hodgkin’s lymphoma. She ended up in M. D. Anderson in Texas. She had great medical care, but not everyone is able to survive their cancer long term.
Wishing you peace as you continue on in your caregiving journey.
Since she is refusing care, maybe she is ready for at least trying palliative care to start and then getting evaluated for hospice. If it were my mom, I would probably skip right to a hospice eval. They will tell you if she qualifies.
I would refuse to treat cancer in my mom with so many issues, if it were my decision.
Again so sorry and I wish you good luck and peace as you move forward.
How old is your mom?
As we age we get so tired and when ill, especially so. Your mom may have aspirational desires to do all the things offered to her but the reality could be she just doesn’t have the energy to actually participate.
No doubt your mom is in decline. I think you have a good idea to speak with her PCP. Let us know what you find out.
We care.
Does she still wish to go to the doctors office or the hospital? Have you discussed hospice with her or her doctor?
Sometimes people feel they have given up when the choose hospice. From my experience it is a kinder, more gentle way to be cared for where the services come to them rather than them having to go out.
By your mom refusing the therapies you mention, it seems she has already made the decision for herself, though informally.
It is time when the expected life expectancy is less than six months and the condition is incurable.
I’m sorry. I hope you have help and are getting rest.
she has a Pulmonologist and PCP appointment this week. I did discuss with the Psych and he talked to her about why she doesn’t want to do the therapy. She will tell you yes I want to live, do the therapy, walk again. But she doesn’t follow thru. I even try to do the exercise along side her to encourage her. But nothing happens on her end. Looking at photos even the last 6 months her face has changed so much, and she looks so frail. It’s like she has given up.