Hospice

My mother has reached a steady state now enough that disqualified her for Hospice which is a good thing; however, I have grown accustomed to having a nurse come weekly. I’d like to share some of the things I observe while my mother was under hospice care.

1. The attending physician must submit the patient for hospice care.
2. Once the referral is accepted (by which ever hospice program your insurance uses) you will receive an “inpatient” visit. During this visit I met with the intake nurse who conducted a physical of my Mom. Taking her vitals and asking me a series of questions. During this discussion I learned that I could get a hospital bed one that will adjust both head and legs and lower and lift. I needed the lifting portion as changing my mother in her regular bed began to strain my back! One thing that has helped myself and my caregiver is the use of what we call a pull sheet. It’s a regular sheet that my caregiver folds so that it can be placed width wide on the bed. We place this under the chucks pads and then Momma is laid on top. What the pull sheet allows is for us to grab hold of that sheet which we ensure extend a little further on the ends to roll Momma from side to side when changing. This relieved the strain on my back and is more comfortable for Momma. We place the sheet so that it lays under her mid thigh and her shoulders. We grab the ends of the sheet and pull towards us and it brings Momma with it! We also received a recliner. I didn’t like but my caregiver used it for Momma transferring her from the bedroom into the den to give her a change of scenery.
3. Hospice personnel will come every week to check the status looking at vitals and overall progress or decline of the patient. They take over all supplies that are needed and will send out weekly resupplies.
4. When it comes to medications hospice normally will not refill medications that they do not deem vital. My my case all the memory medications that my mother was one and blood pressure meds. To my surprise that did refill most but the ones that they would not were continued to be filled by my previous method which was MEDICARE. I have been told that this is unusual so I’ll just thank God that it worked that way for me. But I don’t want you to be surprised if they will not.
5. Hospice is there to assist you and your loved one in the death process. A social worked came out and talked to me about WILLs, Health Directives, Do Not Resuscitate (DNR) documents, funeral arrangements. To my mother’s and my credit we had all those things in place BUT I didn’t know about the transferring of the body. Since we are originally from Texas momma will be buried there in a plot with my Dad. I was able to speak with a funeral director here who walked me through the process of transferring . Turns out it’s easy I pay for fee and flight on my end. I chose this because I have the funds and can pay immediately; however, that fee can be included in the funeral cost by the gaining funeral home and they pay the transporting funeral home (not ideal). I also spoke with the funeral home who will be the recipient of my mother’s remains so that we were on the same sheet.
6. Hospice may not treat developing issues such as colds, bed sores or should I say they sort of monitor but didn’t treat. I later found out this is the norm because they specialize in end of life care. My particular hospice team didn’t have a wound care specialist and my mother had a bruise that turned in a wound then just exploded. I was at my wits end and I was praying. It was during that pray time as I spoke to the Lord and asked for help. I suddenly got a vision for this local pharmacy that I had not been too. Why would I go there when we have CVS and Walgreen BUT I did. When I got there I spoke with a Pharmacist and showed her my picture of the wound. She immediately asked if my mother could take vitamins which she could. She put her on Zinc and Vitamin C then she stated “I’m going to make you a cream that we use in the hospital for wounds.” What I didn’t know was this this little local pharmacy had compound pharmacist. This are the pharmacist that make the creams and meds!!! She made the cream and told me to use it three times a day along with the cream the hospice team had been using. That cream (hospice) was only keeping the wound moist but was not promoting growth she told me . I found it interesting because the hospice team told me and my caregiver to change the wound every three days but it was draining so we were changing it multiple times throughout the day. The cream had and antibiotic in it (I could smell the wound which is a suggestion of an injection and although the hospice team using prescribing antibiotics for 7 days periods of time the smell would always return) silverdine I believe and zinc. I began using it immediately and in four days I could see improvement. The next week when the hospice nurse arrived I showed her the cream and asked it we could get it prescribed through them since this was a sample. She did and I paid out my own pocket. About a month passed and the Nurse practitioner came and told my caregiver to stop using it and return to the med that only kept it moist. I was out of town so didn’t fine out about this under I returned. As it happened when I returned she , Nurse Practitioner, would be there in 4 days. I called the local pharmacy and asked if the pharmacist would be there and if I could call her when the nurse practitioner arrived. When the Nurse practitioner arrived I told her of my concern of us stopping the one thing that had been helping in the first place. She said the silverdine was eating the tissue. So I called Lauren the pharmacist and they had a conversation. Lauren made a new cream and I picked it up that day and we used it. The Nurse practitioner told me that the best we could hope for was that it just closed but the tissue would not fill in. In my mind I was thinking “Nope it will heal completely” Within two months the would had COMPLETELY healed the tissue filled in and the wound closed. The wound had been open the beginning of March and it wasn’t until Jun when I went to the pharmacy and received the cream that the wound began to heal. I said all of this to say the person whom you are taking care of if YOUR loved one and YOU must be the advocate for them. I was determined that when it time for my mother to go be the with Lord it would be as a result of the disease and not anything else.

here are the before and after pictures!!! Gross but then SUCCESS!!

I call the cream the magic cream and we use it on everything. Part of my challenge is my mother is bed bound so her skin is paper thin and her muscle tone is gone. However she has no bed sores or pressure ulcers!!! Praise God!!!