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A week ago yesterday we brought my MIL to the hospital after a couple of days where she started getting hostile and combative. We found out she had a UTI (which has since been cured) and one or more symptomless (except for extreme confusion) strokes, but the doctor was concerned about a pleural effusion and did a needle aspiration and biopsy.

The fluid is exudate, meaning it could be anything from pneumonia to a tumor/cancer, but we still don't know yet.

She went to a nursing home Thursday and we plan on taking her back here in a couple of weeks.

My frustration stems from the fact that as many times as we've asked and asked and asked about getting hospice care to come in, the doctors (both her own and the nursing home physician) are reluctant to give her a prognosis that would enable us to get hospice here at home.

Come on!!!!

She is five months shy of being 94. She has COPD and CHF...diabetes....she had a couple of strokes...has mid stage Alzheimer's, and possibly has lung cancer (although we don't know yet).

Why is it so difficult for someone to look at all of this and be reluctant to speculate that she could indeed only have six months left????

All we want is a little help here to make her last days (months) easier and not filled with stress when things start going downhill and there's nobody here but me and Mr Pip to deal with it!!!!

very angry and disappointed
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Sounds to me you are in desperate need of a major consultation with the doctors. With all I have heard and witnessed with Hospice, along with doctors suggesting using them, I am finding it disturbing that they would not encourage the use of their services. My father never was given a *time* frame on his life span, however, his care was becoming more and more difficult and he is 86yrs old. Hospice didn't refuse his case for not having less than 6 months to live. Please make an appt with the doctors ASAP. Keep us posted Angel.
So far we've talked with three doctors...her own (who is now on vacation)...his temporary replacement...and the doctor at the nursing home.

So far we've been turned down by all three for hospice care.

I've been reading about it, and how frustrating it is for some families when the doctors won't order it until it's almost too late to be of any use to anyone.

Oh, and to make it even more frustrating, the nursing home had us bring in Mom's Living Will, her DNR orders, and Mr Pip signed a DNH paper (do not hospitalize).

She's becoming increasingly combative, and her mind is slipping away more and more each day, even though she is able to feed herself and go rummaging through other people's stuff. She's just not "there" much anymore, and I wonder why they think she has more than six months.

Today is a holiday, so we'll probably be seeing someone tomorrow, I hope....

I feel kind of betrayed that her own doctor decided to go on vacation without even telling us he'd be gone, although he did call Thursday evening on his way to the airport.
Oh sweetie, don't be concerned about the nursing facility wanting the living will, it is just to insure what is to happen when she passes on, if she is in their care at that time.

The DNR and DNH is necessary, with it by law they must do as she wishes. If she has a DNR already done they do need it.

I know when my dad went into a nursing facility for rehab after his illness they too wanted his DNR and living will. And we were told without it on file if he did crash they would perform recesitation. So it is a good thing all these little details are being taken care of for you.

You have nothing to be concerned with on this subject of paperwork.

I am disappointed that they will not prescribe hospice. My Father was diagnosed with terminal cancer - in late October given 1-2 months - then re-hospitalized in mid November and given 1 week. We are now over 14 weeks past his expiration - and his Doctor REALLY pushed hospice - which so far I have refused - only because I want him to continue getting treatment for the bone cancer. I fight with myself everyday if it is time for hospice. In my case - it seemed that they were TOO aggresive about hospice - there must be some happy medium. I live in Pennsylvania and the hospice person I spoke to says you can be on hospice for up to 1 year - you just have to be diagnosed with a "terminal" illness and that terminal illness is expected to be the cause of your death. She even explained to me that some people still even hold jobs when on hospice. I am not sure why they are giving you such a hard time about getting this. I would continue to push if you feel this is the best route to take - you deserve it and so does she. I have heard nothing but wonderful things about hospice - they care not only for the person who is dying from their terminal illness - but also the family itself. I am "sold" on the hospice services - but not yet sold on given up the "treatment" side of things. I really think it does help with the pain and slows down the spread of the cancer to other bones. And I found that very interesting that not only are there DNR's but DNH's - I never heard of a DNH. I will pray for you that you are able to get this hospice thing straightened out....

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