Nursing Homes and Hospice: A Good Team

  • No one should have to die in pain. Medical people have the means to make people comfortable during the death process. But sometimes it takes an advocate to make things happen.

    My dad had been in an excellent nursing home for nearly ten years. The nurses and assistants who cared for him were wonderful. I visited daily. My sister drove in from out of town each week, to visit. He had good care. But when it came to convincing the doctor who walked through monthly, or the Physician's Assistant who came weekly, that Dad was in pain, we ran into a brick wall. They read his chart. They saw that he slept a lot. As far as they were concerned, he was okay.

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    Dad's dementia was such that he could no longer articulate his pain, but those of us who knew him could read his body language. We knew he was suffering.

    When I visited, I'd see him rigid, torso and head up off the bed, straight as a board. He'd grimace and pound his fist into his hand. Over and over. Bang. Bang. Bang. He was trying to knock out the pain. I knew it. The nurses knew it.

    I talked to his floor nurse and she tried hard to convince the doctor that he needed to be put under hospice care. We knew he was dying, and that hospice would take care of his pain.

    The doctor disagreed. Dad slept. Therefore, he was comfortable enough. Period.

    The whole thing was a nightmare. I knew the nurses were doing everything they could. I was furious and trying to figure out what to do next when Pam, the floor supervisor, called me at work. She said she'd succeeded and hospice would soon be calling me. Wheels were in motion, paperwork would begin. Soon Dad would be under the care of hospice.


    "What happened?" I asked Pam. "What changed?" She just chuckled and said, "I went over a few heads." Then I remembered that Pam was married to a doctor. My thought was that she wasn't intimidated by doctors and followed her gut. I'll never know exactly what she did, but I'll always be grateful.

    Within twenty-four hours Dad was under hospice care. He slept peacefully and was cheerful when he was awake. From the time hospice was in charge of his care until his easy death, Dad was comfortable. I've blessed hospice ever since.

    Meanwhile, my mother was suffering a great deal from severe arthritis and the cancer that was spreading throughout her body. She was too frail to withstand tests to determine the extent of the cancer, but the doctors did prescribe drugs to ease her pain. The trouble was nothing helped. They even gave her liquid morphine. Still, she suffered.

    Finally, as she grew more and more frail and we knew her time was limited, she was, without a battle, placed under the care of hospice. Immediately, hospice gave her a drug for bone cancer, and she was pain free. I must say she was also inhibition free, which didn't help her personality, but no one cared. She was hard to please and would boss everyone around. But she was out of pain, and that's what mattered.

    Many people feel hospice is only for those still in their homes. But for people like my parents, the nursing home is their home. When hospice care begins, hospice takes over all medication, but the nursing home staff and family continue in their roles as caregivers. The difference is that they have help from hospice. More people means more attention. Another chaplain. Another social worker. More nurses. What a blessing!

  • Medicare pays for hospice care in the nursing home, as it is considered the patient's home. Many private insurances pay for hospice care in the nursing home, as well. Do check into hospice, even if your loved one is in a hospital or nursing home. If they are terminal and could be more comfortable than they are, work to be sure they get the care they need and deserve. Because no one should have to die in pain.

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Published On: March 29, 2007