<p>nj2011mom- re: Medicare supplements- one of the key variables to compare (and state agencies that regularly review options by type of policy are a great suggestion) is the coverage for skilled nursing care post-qualifying hospitalization. It is great to hear about your mother’s excellent health. If she is hospitalized, elders do quickly become weak after being bed-ridden for even short periods of time, so skilled nursing gives them PT support, post-illness/injury care and gets them on their feet to return to their prior living situation if possible. If I understand correctly, Medicare covers up to 21 days of this care and then day 22 up to day 100 there is a large co-pay (@$150/day now, but check Medicare site). While some people never use this, others may well need it at some point or other. It adds up quickly, but can provide a great alternative to returning to a situation without adequate care pre-maturely or conversely making a nursing home decision without the advantage of assessing how close to their prior baseline an elder can get.<br>
Good luck with your research. I have found the business office at a good skilled nursing facility to be an excellent resource for how to gather information about Medicare supplements in a particular state. I believe the plans are identified by letter and have some consistency by plan, so you can compare “apples to apples”.</p>
<p>I couldn’t help with meals on wheels or grocery amounts. I am really grateful Mom is in AL where they provide all the food. </p>
<p>medicare supplement is a must have, but I am just keeping Mom’s unchanged. I am afraid to rock the boat. but both senior services and the support staff at the AL place are very knowlegeable about the plans. Guess they see who pays, plus they have speakers come in to address it fairly often.</p>
<p>I am logged in because Mom is in ER. She has worried about her trip to Thanksgiving which I arranged. She was to fly non-stop, short hop up to see my brother and his family who are all meeting in that town. She also got a Dr. bill today (eye Dr. that forgot to bill me not her) and freaked out about it. Got the front desk to send it to me which was actually exactly what I wanted her to do. </p>
<p>She has a history of heart problems, but she also has a history of crying WOLF for attention or for anxiety. The nurse thought she should be taken to ER. I told her (after a long pause) that my money was on anxiety and that they couldn’t do anything for her anyway. But the nurse wanted her to go so OK. If they try to do another angiogram, I will have a fit. She has had 7 or 8 (seriously) with NOTHING found. Even demented she knows what to say to get what she wants. I just hope she hasn’t over ridden her DNR that I had in place. She signed it long ago, NOT at my instigation… but I was the one who pushed and got it registered.</p>
<p>eso, I hope your mom is OK.</p>
<p>I’m checking in to tell you that my Dad passed away last Saturday evening, November 16. I’m doing OK and so is Mom. </p>
<p>A few days before, I had a meeting with a social worker from hospice, the director of nursing at the SNF, and the discharge planner. I felt so much better afterward, feeling that at last I had a team all working toward the same goal, which was to get Dad out to a Board & Care as quickly as possible. One thing that was disconcerting, though, was that they all seemed to believe that Dad was declining, but he still had a bit of time. Based on the material I’d gotten from hospice, I thought I was seeing definite signs that the end was imminent. </p>
<p>I saw Dad on Friday morning and he seemed worse than on Wednesday afternoon. Then on Saturday I took Mom to see him. He was largely unresponsive and couldn’t communicate, but he seemed agitated. I soothed him as best I could and we left pretty quickly, not wanting to upset him.</p>
<p>That afternoon, a neighbor called kind of out of the blue and asked about him. I told her about the agitation, and she asked, “Is he that way when it’s just you?” I said No, and she said, “He’s worried about what will happen to your mom. Take her over and let her spend some time with him and reassure him that she’s going to be OK.” I thought about that all afternoon and decided I’d take her over Sunday morning. </p>
<p>Just after dinner on Saturday, the SNF nurse called and said that Dad had spiked a fever and was having trouble breathing. Ever since the infection that almost killed him a month before, I had known that the next thing that happened would be the end, so I went over immediately. I can’t say if he was conscious or not; his eyes were half-open and glazed and he was unresponsive to my voice and my touch. But somehow I felt that he was aware on some level, so I took his hand and told him I was here. After a few minutes, I went outside to remind the nurse about the DNR, but I was concerned about discomfort. The nurse said that ER wouldn’t be able to do anything that wasn’t already being done, so we decided against calling 911. I went back in to Dad, took his hand, and told him that I was going to get Mom and we’d be right back.</p>
<p>I dashed next door to Mom’s AL and scooped her up. During the dash back, I told her what my neighbor had said, and that I thought maybe Dad just needed to hear from her one more time before he could let go. We went into the room, and I settled her into a chair so that she could hold his hand. Then I went to the other side and took his other hand and said, “Dad, it’s N______. I’m here with Mom and I promise you that I’m going to look after her. She’s going to be OK. You don’t need to worry.” </p>
<p>I left them alone for a few minutes, then went back in and sat down next to Mom, one arm around her, and holding Dad’s hand with the other. We sat there watching his chest rise and fall, labored. Then – not more than 5 minutes later – it went down, and didn’t rise again. No struggle, no distress, he just stopped. To my dying day, I will believe that that goodbye with his wife of 65 years, and my promise, was all he needed. Then he was ready to go.</p>
<p>My fervent prayer since the beginning of his final decline a couple of months ago has been that I would be with him at the end, holding his hand. God gave me that and so much more that I didn’t think to ask for – Mom at his side, a peaceful end, and the final bit of business settled. When I talked to D later that night, she said, “No regrets, no loose ends, no wondering if you did everything you could.” And she’s right. The way it happened has been enormously comforting to our whole family, and especially to Mom.</p>
<p>Like I said, we’re doing OK. The AL staff has been fantastic with both her and me. I spent that first night with Mom, and for the next few days, most the day and evening. My brother came on Wednesday for a couple of days to spell me, and the whole family is gathering next week for Thanksgiving and the memorial service. My DH, who is Mr. Practical, has done the little things that I’m too scattered to think about. Like that first night, I took Mom back to AL, then went back to SNF to take care of the necessary details. While I was waiting there, I called DH to give him the news. After condoling for a few minutes, he said, “Do you want me to call D?” (Yes) And “Do you want me to go over to your mom’s until you’re finished there?” (Oh yes, please…) When I got back, he was sitting next to her holding her hand, and he stayed by her side for a couple of hours while I talked to my brother and D and the AL staff who came in. Then before he left, he gave me a couple of things I didn’t even think about: my phone charger (it was almost dead by then) and a couple of benadryls (for sleeping). He’s been my rock. </p>
<p>Then there’s my virtual community. You all have walked this difficult path right along with me. For that, I can never thank you enough.</p>
<p>My condolences, LasMa. But so glad you and your mom could be at his side.</p>
<p>Condolences, LasMa. It was great that you could bring your Mom to reassure your Dad as you both did. </p>
<p>Kudos to your supportive husband, too. </p>
<p>You’ve done everything possible. I wish your family a most peaceful Thanksgiving.</p>
<p>I got teary reading this LasMa. What a blessing you are to both of your parents. You will soon have the all the good memories and not just the pain of the passing. I’m sorry for your loss.</p>
<p>I am so sorry for your loss, LasMa. I am teary too. I appreciate you sharing your story- the little details - the neighbor’s insight, your H’s support- all you have done for your family- such an example of how loving people treat each other.</p>
<p>LasMa, I am so sorry for your loss and so glad you had a wonderful ending to hold onto. What a wonderful report. YAY for everyone behaving well. Many virtual hugs.</p>
<p>My mom was fine. They sent her back to the AL place about 10. I am not sure if they even did the CAT scan after I talked to the Dr. She said they didn’t do anything for her, including getting her dinner. That is why I hate for her to go to the hospital by herself. I know the AL place doesn’t have staff to sit with her one-on-one while she was there, but I sure wish they could have sent a med aid in to just see if she needed a drink and a hug. They are right next door after all.</p>
<p>LasMa- so sorry to hear of your loss. How comforting it must have been to have been there with your mother. Navigating these situations with clarity about the goal helps.</p>
<p>It’s also great to have the support of your husband. I hope you are taking good care of yourself as you anticipate the memorial service and the family gathering. Many thanks for sharing your experiences, allowing CC to benefit from your wisdom.</p>
<p>Hi all, I am new to this thread. I’ve read back over several pages and have been so touched by your stories. My question may have been asked before, but I don’t think I can handle a full day of reading the thread, so forgive me if it has.</p>
<p>I’ll start with the background -</p>
<p>My mom (78 years old) has moderate dementia and metastasized breast cancer, and is almost completely deaf. Her doctor calls her “happily demented” and she is very compliant and sweet. She still knows her family, but obviously is not able to read or follow a TV program. She is wheelchair bound due to painful tumors in her femur. She sleeps a great portion of the day.</p>
<p>She went into a Lifecare community 5 years ago, after my dad died. She has moved from independent living to assisted living, and finally moved in August to the nursing home. Because it is a Lifecare community, her monthly payment is very affordable (her monthly fee is the same as when she moved in) so finances are thankfully not a concern. She is receiving excellent care at the nursing home, and does enjoy the dining room and special events they have. She does some physical therapy, and has interaction with a lot of people. I am able to visit her almost daily, but she generally just holds my hand and sleeps.</p>
<p>Last month my sister and I met with her medical team and outlined her end-of-llife care. She will be getting palliative care only, and is expected to live less than 6 months. They asked if we wanted hospice care. When my dad died, hospice came to the house and administered meds and bathed him, checked on my mom, and served as a liaison with his doctor - all very helpful, since my sister and I weren’t local. Apparently hospice here does more, but I’m not sure exactly what they do that the nursing home doesn’t do.</p>
<p>The question -</p>
<p>Has anyone had hospice come into a nursing home, and what exactly did they do? Should we take advantage of it?</p>
<p>mamaduck - welcome to the thread. My husbands grandmother had hospice at a nursing home. It was very helpful, another pair of hands making certain she was comfortable and well cared for, I don’t know that nursing homes can be as hands on as perhaps you would want for your mom. I’d say it probably wouldn’t hurt and if it was offered I’d try it and see.</p>
<p>We have had made progress on my mom’s end. Someone called her and let her know a 2 bedroom was becoming available in the only building she’ll consider moving. She’s calling her “connection” after church to see if she can get over there and find out more. This would be a HUGE blessing - winter is REALLY tough on her and it would be ideal to get her in there now. She’s really struggling where she is even with my niece living with her.</p>
<p>mamaduck- welcome to the thread. I hope you find it as helpful as I have. </p>
<p>As to hospice in a nursing home setting, I have some experience. In part, I think it depends how complex a patient’s health variables are, how sophisticated the medical staff at the SNF are and what kinds of ancillary services could be relevant to the patient and family. Hospice often offers extremely good medication management, especially for pain, with access to consultation from some of the best geriatric pharmacology specialists if needed. If there are concerns with this, having an extra set of eyes on the medication options can be a great resource, especially if one is balancing the desire for alertness with the need to reduce severe pain.</p>
<p>Hospice also offered to have people come to play soothing music for my mother and sit with her if family could not be present. They were equipped to navigate medication options with nursing home doctors and had experience with a broad range of options, particularly relevant to my mother, who needed major pain management, but was also with it enough to want to be able to converse until her final week and very sensitive to medications. Hospice was also great at laying out the process of death and helping family members grasp it as it unfolded. </p>
<p>I would suggest you meet with a member or two of the hospice team that would be involved in order to hear what they have to offer, how they would work with her present medical team, assess their fit with your mother and family, etc. Then you can make an informed decision. Once a patient is on hospice care, it is important to note that any pro-active steps to treat and assess the illness/es that qualify them for hospice require a temporary withdrawal from hospice, as Medicare will not pay for it. Let hospice review current regs with you, it may not matter at all. My mother was on hospice a bit pre-maturely and wound up needing to go on and off a couple of times for comfort procedures that also prolonged her life (she had quality of life at the time). It worked out well, but is something to be aware of if you opt for hospice. As far as I could tell, it was mostly a matter of paperwork done by the hospice team.</p>
<p>Best with all your decisions. I am happy to hear that your mother is so well situated.</p>
<p>LasMas - I’m sorry for your loss. Thank you for your heart-warming account of your fathers death. What a wonderful DH and neighbor.</p>
<p>LasMa: So sorry for your loss, but how comforting that you and your mother could be there together. What a perceptive neighbor! My MIL, dying of cancer, held on until DH could visit her for the last time. She passed away about 12 hours after seeing him.</p>
<p>Lasma, I am so sorry for your loss but it is heartwarming to read that you and your mom could be with him when he died.</p>
<p>My mom lingered for many years after neurosurgery and subsequent radiation from which she never really recovered. In 1983, during her last 24 hours, she had tremors. She was home and my dad had an LPN with her, although after caring for her for seven years, he had disengaged by that point. I went to their house and the nurse told me that she was totally unaware by that point. But when I talked to her and touched her, she started shaking even harder. I told her that I loved her, that Daddy loved her even though he couldn’t bring himself to watch her die, and that she should feel free to let go now, if she was ready. Her tremors lessened a bit and I went home. Not five hours later, I got the call that she was gone.</p>
<p>I don’t think it was my imagination that she responded to me and all I can do, not believing in an afterlife, is hope that it was a comfort to her that I was there. Both of my brothers lived far, far away so at least she had a family member with her.</p>
<p>For sure it was a great comfort for your mom to be there. You are a good daughter, with a wonderful husband! My sympathy and empathy to your whole family and of course to you too.</p>
<p>LasMa, my love and condolences to you. You did everything you could do (and then some). Hang on to the peace, love and comfort you gave your mom and dad – it will help you get through the coming days and weeks. </p>
<p>Having walked this path, I also believe your dad could hear you and waited for you to bring your mom to him. We know Mom was able to hear us (and the music) until pretty much the end. </p>
<p>Three cheers for spouses who come through when the going is tough.</p>
<p>Lasma, my condolences for your loss. It was as good as it gets, I think in terms of how he left this world. Hugs to you.</p>
<p>LasMa: condolences on your loss.</p>
<p>LasMA- condolences. And what a lovely story of the end. Those will be good memories to have, it is nice to know someone died surrounded by people who love him.</p>
<p>LasMa, my thoughts and prayers are with you. I’m glad that you and your mom were with your dad when he passed. A hug for your husband too! </p>
<p>Mamaduck, welcome to this thread with incredible compassionate and knowledgeable posters. I agree with travelnut about a hospice consult. I have a close friend who is a hospice nurse and they can offer a wide range of services.</p>