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I hope you get the advice your looking for.
I had met the chaplain at my mother’s Memory Care. I was very impressed with his manner.
THEY contacted the doctor at the MC.
Ours is a faith-based hospice company. Others that interest you may or may not be.
You can call and speak to as many companies as you want. You don’t have to have a doctor’s note to make these calls.
Before my mother moved to Memory Care, her primary doctor was ZERO help in caregiving information. I just don’t think they know that much about it. Even though this was a doctor for adults, her focus was on meds and moving on to the next patient in her busy practice. Not complaining. This was just the reality of situation.
Many doctors do not like to refer to Hospice or Palliative care because many see it as a "failure", doctors are taught to CURE not on how to allow a person to die with dignity and a better quality of life in the last months or in some cases years (or days) of life.
And...there are 2 basic types of Hospice.
FOR profit and
NOT for profit.
do your research, look at reviews and interview them just like you would any other medical service.
Sometimes, you have to be insistent with the doctors, for all sorts of different reasons. Having paperwork in hand will make things easier sometimes; sometimes you just have to be the "squeaky wheel" to get results.
I would start by you and sister writing down SPECIFIC ways that mom is starting to fail: giving the doctor a vague "she's doing worse" is not as effective as "Monday. she only was able to get out of bed for an hour; Tuesday, she only ate about 4 ounces of food; Wednesday night she cried from 2 AM to 5 AM constantly that she was in pain..." and so on. Because using terminology like "she's doing worse" is so very open to interpretation that doctors can let the comment pass by without doing anything. I found, when dealing with my mother's doctors, it always got more attention and better results if she or I gave very specific details.
If her doctor(s) still refuse to honor your request for a hospice/palliative care evaluation, call around to the various companies and talk to them about what's going on. They often can help with any logjams that mom's doctors might be creating, even if they're doing so inadvertently.
I hope you can get her doctors to agree to hospice/palliative care; it will make a world of difference to her and to you and your sister.
Good luck.
additional thought, to relieve you and your sister a bit medicare should cover an in home nurse. maybe not 24 hr but some relief