The difference between long-term care and hospice care - 2024 09 25

 

This morning Adele and I have moved our base of operations upstairs. Mom is downstairs in the basement suite, where I lived with her until yesterday.

Yesterday we took the step of putting Mom into Emergency Long-Term Care. 

The tipping point for us, after three years of family caregiving, was that Mom could no longer hold her weight to get to the commode, and I could not hold her weight to make up the difference. I purchased a bedpan from the Amazon, but had never used one and had no idea how to use it with Mom. The stress of toileting was overwhelming.

Emergency Long-Term Care has a three month waitlist. In the interim, while we wait for a bed to become available within our healthcare authority, Mom is provided with 24/7 professional caregiving in-home. This means I do not have to worry about her toileting anymore. It also means Mom has caregivers in her suite at all times, and I don't have to be there in the same way.

There are many questions to answer, to shift operations from me and family members, to a professional team. All the aspects of Mom's care routines - scope definition, schedule management, resource assignment, communication and logistics, quality assurance, procurement and security, risk management, stakeholder interest, personnel roles and responsibilities, organizational structures and protocols - these are all impacted and subject to re-configuration at this time.

Mom moved home with us on Nov 1, 2021. By Nov 26, her GP decided she needed to go onto the Palliative Care Registry, which gave us a 6 month timeline for her life expectancy. She survived and exceeded those expectations, one six month period at a time. This summer we finally took the step of signing Mom into home-based long-term care. Almost immediately she started to have issues with her strength and her ability to support her own weight to make the transfer to a toilet. That was in July. It took two more months for us to reach this moment of asking for emergency long-term care. 

The situation now is that the in-home emergency long-term care is a stop-gap until a bed becomes available. At that point, there will be another assessment as to whether Mom should go to a long-term care facility or whether she should go into hospice care. If I understand correctly, the deciding factor will be whether Mom's life expectancy is three months or less. If she is expected to pass away in less than three months, she will go into hospice care. If she is expected to live longer than that, she will be placed in a long-term care facility. 

We will not be able to choose what facility Mom goes to. The waitlist for family choice to put their frail elder into a nearby long-term care facility is two years. However, once Mom is in a facility, if another bed opens up nearby and we want to move Mom closer to our neighbourhood, we would be able to make that request.

This morning when I checked on Mom she was very sleepy and weak. She needed help to get a sip of water. She wasn't able to put her dentures in. She was having difficulty talking, her speech was slow and slurred.

When she could speak, she asked, "Did you sleep well last night?"

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