My Blog

November 20, 2017

Elderly Mothers and the Pros and Cons of Hospice

It was the battle of the doctors that led us to call Hospice.

The wound care doctor noted the gangrenous toe and the lack of blood flow in my 98 year-old mother’s right leg. He was determined that we should immediately admit her to the hospital for surgery. He insisted that a “roto-rootering” of her leg, putting in a stent (think I have the right term now), would prolong her life and clear up the problem.

Mom’s regular doctor said no. The surgery, he said, would pain and confuse Mom due to her severe dementia. The chances of the surgery actually changing the direction of the infection were minimal. He said it wasn’t worth it. We agreed.

So we called the same Hospice company that has been sending out the Home Health Care nurses, for which thank you, dear Big Brother government. We had no idea what Hospice was, who did it, who paid for it, and where it started. Back to research.

It seems that Hospice is sort of Dr. Kervorkian in slow-motion. He was the doctor back in the 1960s who assisted people determined to die. Hospice, it seems, offers the option of leaving a terminally ill patient in a home environment and then focuses on pain management and preparing the patient, and the family, for death of the loved one.

All medication and extreme life-saving methods are removed and the family agrees not to call 911 when there is a crisis. There are no resuscitation measures, no rushing paramedics, no screaming sirens, no jolting electric paddles, no masked doctors performing bloody surgeries. If the patient should fall and break a bone, and 911 is called, the patient goes off Hospice. But the patient can be reinstated once they are back home.

Of course, I had to find out more about Hospice. Blessings on Google. It seems Hospice began back in the nineteenth century. To quote from Google, “the word “hospice” was first used in the mid-1800s to describe caring for dying patients by Mrs. Jeanne Garnier, the Founder of the Dames de Claire in Lyon France. The Irish Sisters of Charity adopted it when they opened Our Lady’s Hospice in Dublin, Ireland in 1879 and then again when they opened St. Joseph’s Hospice in Hackney, London, England in 1905.” Several organizations cropped up in the U.S.

In the United States, during the 1950s, “Dr. Elisabeth Kubler-Ross wrote a book she based on over 500 interviews with dying patients. On Death and Dying became a best seller and gave people a first-hand insight into the emotions and stages that people face when they are terminally ill. In her book, Dr. Kubler-Ross pleaded for better home care as opposed to an institutional or hospital setting. She argued that patients should have a choice when it came to their healthcare and promoted their ability to participate as much as possible in the decisions that affected them.”

And the final question, how come there are so many Hospice companies now? “In 1986, Congress made permanent the Medicare Hospice Benefit and the various States were allowed to decide whether they wanted to include hospice in their Medicaid programs.. . .Estimates show that there are approximately 3,200 different hospice programs in the United States, Puerto Rico and Guam.” Well, I’m thankful they are around but now I understand why our St. Joseph’s group was plenty anxious to have us choose them as our company. They fight for clients.

We called St. Joseph’s Hospice out of Houston. The first to arrive was the manager or maybe she was the outreach person. She had an entire notebook of information and papers to sign. We are now committed to St. Joseph’s for life, or death as the case may be. She also had us post the “Do Not Resuscitate” form on the refrigerator, although Brian, the chaplain took it back for the doctor to sign.

The nurse, who came the following day, checked Mom over and had us sign more papers. She also brought gloves, more diapers, bed protectors, and wipes. She accepted our decision to use Homeopathic remedies and, since she is half Hispanic, was very familiar with the herbal medicines that we were using.

The following day, the delivery truck from Bryan showed up with a hospital bed and a bedside table. We moved Mom’s big (much more comfortable bed) over against the wall and put the hospital bed closer to the bathroom.

As the “night shift” I get to sleep on the big bed to watch Mom at night. Makes for a very unrestful night. Three to five times a night it is necessary to get her up to the bedside toilet, change her and her sheets when she doesn’t make it, fresh diapers, and back to bed, then changing the diapers when she forgets to pull them down to sit on the commode. Makes for a long night.

The hospital bed has a plastic air-mattress made of many small fist-sized cells that inflate and deflate to prevent bed sores. Well, I can tell you, it feels like sleeping on a bed of rocks. I had to sleep on it one night when Mom managed to crawl over into the big bed. I found out the next day, after a night of torture, that it is possible to decrease the air pressure to soften the cushioning. Definitely necessary. And I could certainly understand why Mom, even in her demented state, wanted to be back in the big comfy bed.

I was under the impression that the Hospice would provide daily care or at least nurses to treat her leg. Nope. As soon as they saw I had my own caregivers and that we were doing the homeopathic stuff, they said they would check back in two weeks. They were gone.

No, not quite. The Chaplain came. I was at a meeting in Houston, so poor Sister had to discuss religious issues with him for several hours. I guess they are used to families screaming and crying and going through great traumas which they try to assuage with religious cant. I was glad she handled it and not me.

We aren’t either screaming or crying. It’s in the Good Lord’s hands and all we can do is make her comfortable and feed her. And she eats like a stevedore. So, the refrigerator is stocked and we are busy cooking up herbal remedies to soak her foot and pills to increase her circulation.

So far, it seems to be working. She may live to be 100.

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About Caroline Castillo Crimm

Retired Professor Emeritus from Sam Houston State University, interested in writing novels and speaking about topics such as the history of Latin American. Would like to share the AMAZING world of the 18th century in Northern New Spain, that's Spanish Texas and Mexico!

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