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With hospice, the trips to specialists stop, and the hospice doctor becomes Mom's doctor. (Ending those relationships with the specialists is remarkably freeing.)
Once Mom's on with hospice, the whole focus on her care shifts to her comfort -- hers as well as yours. If you have a good hospice provider, it's a wonderful experience for everyone. If you aren't clicking with them, get another provider. They'll coordinate with the first company to make the change as seamless as possible.
I think we're all brainwashed into thinking it's 'the right thing to do' to extend our elders' lives to 100, even if they're living in misery, pain and advanced dementia, when it makes NO sense at all! Allowing nature to take its course is a much better alternative, in my opinion, than taking extreme and expensive (not to mention invasive) measures to keep them alive when there's no quality of life left!
Wishing you the best of luck devising a plan that works best for you and your mom.
When you say your mother is dying, what do you mean by that? Just because she's 92 or because there is a terminal issue or some sort? If she is actively dying or does not wish to treat her issues, perhaps looking into a hospice evaluation might be in order? Or at least finding out about shifting to palliative care?
With my 95 yo MIL, I ask my husband and her - if we go to see the "insert doctor like neurologist" and they say you need an operation will you do it? She says no and we agree so we don't do the appointment.
Does anyone go to these doc appointments with your mom?
Some things, like a proper prescription for glasses if she still needs them for TV or reading, etc., make sense.
But look at the purpose of the appointments and what can be gained? Neuro - why? Cardio - why? If there's an issue, will they operate? Would she want life prolonging surgery? All surgery has risks so at her age it's iffy at best for the risk/benefit analysis.
Although the OP's profile page includes a long list of their mother's health problems none of those things are imminently fatal and neither is her age - my mom was living independently with most of those same conditions in her early 90's. I was furious when a doctor told me "sometimes they just get tired" when I took my mother to the hospital seeking a reason for her sudden decline - ageism is real and not every 90 year old is teetering at death's door.
If I remember correctly, U of M hospital some years ago issued a mandate disallowing acceptance by doctors of any favors.
Some years ago I was waiting in the lobby for an appointment with a female PCP. It was around noontime, and I saw a delivery person arrive, deliver several lunches to the receptionist, then leave. Just on a gut feeling, I commented to the receptionist that it was generous of the medical firm to provide lunches for staff. She (perhaps in an unrecognized indiscretion) said that it wasn't the firm; it was a medical supplier (I don't recall of what).
That said a lot to me. After the appointment, I never went back to that practice. (And the ease with which the female doctor had recommended meds was just too unacceptable for me.)
If a person presents themselves for treatment, doctors have to do their job and treat them. They're not going to turn people away just because they're very eldery or sick.
I know my mom, with advanced CHF, was more than ready to go into hospice and end the constant round of doctor visits/hospitalizations/ rehab & recovery. When her cardiologist tried one "last ditch" effort and put her on a constant infusion pump treatment, she said "enough", told her cardiologist she wanted the PICC line removed and hospice brought onboard.
There are a lot of reasons that doctors continue to push to treat patients that seem to have no real hope of recovery. I am sure in some instances greed plays a part, as does fear of litigation; however, I believe that not only are many of them (the medical people) hardwired to "do something", many of them have forged long relationships with their patients, and don't want to seem to be "giving up" on their patients. It's for the patient - or their advocate if the patient is unable - to make clear their wishes to their doctors.
If mom has said to you something to the effect of she's getting tired of all the appointments, all the poking and prodding, the never-ending cycle of treatments that don't seem to be of much use, you need to ask her how she feels about seeking hospice/palliative care, and then encourage HER to make her wishes known to her doctors. Certainly be there to support and advocate for her while she does it, but it seemed to me that once my mom was the one who spoke up the doctor was much more willing to engage in the conversation about hospice.
You and mom are in my prayers; this isn't easy for any of us to get through; there are many of us who have stood right where you are now. Making the decision is really the hardest part of the equation; at least it was for us.
Good luck and hugs.
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