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Hospice Questions - Eligibilty 
Créé par Junior75
23 nov. 2021, 19 h 54

I am not sure this is the right place but I'm looking for some guidance on hospice eligibility.  

My mum has terminal cancer.  She is on the palliative care path through our provincial (ON) community care program and was living at home.  Over a week ago she was admitted to the hospital as she was no longer able to walk and barely stand.  Since then her health has declined quite rapidly.  What I am being told is that she does not meet the criteria for hospice yet she is not able to go home and a retirement home may not be an option either.  The doctor has given her 3-6 months to live and each time I see her in the hospital I notice that she is slowly getting worse not better.  All I want for her is as much comfort as possible, somewhere that is as close to home as possible.  

Is there a resource that review the critieria to be eligible for a hospice facility?
23 nov. 2021, 20 h 36

Hi Junior75,
I am sorry that it is such a difficult time for you and your mum (and family). I don't know about eligibility, but wonder if you could post a question to our Canadian Virtual Hospice Ask a Professional  The team is made up of Palliative Care experts and I think would be able to give you direction. They will get back to you in no more than 3 working days. It is good she has you as an advocate.

It must be so difficult to see her health declining quickly. Have the staff been able to provide you with support? Do you have family or friends that support you?

Réponse de Mary09
23 nov. 2021, 23 h 06

Hi Junior75,
First if all I am sorry you are going through this with your mom.  My mother has end stage cancer right now also...and like yours is unable to walk or even sit.  Things at home are becoming quite difficult.  We don't know how much time exactly she has left but it's likely a matter of months.
I'm sorry I don't have any experience with hospice...but why would she not fit the criteria?  I had thought hospice was for people who were expected live six months or less....I'm not sure.  Do you mean for a hospice placement?  Is it possible you could get her hospice care at home?  My mom keeps telling me she doesn't want to leave's very very difficult.  I'm hoping someone can advise more on the hospice question but please know you aren't alone....sending you strength as you go through this difficult time.

24 nov. 2021, 0 h 24

Junior75 I am sending this on behalf of another member eKIM. 

I am sorry that you are going through this difficult time.  I send you thoughts of peace.

After spending 10 years as a resident and family support volunteer, this issue came up over and over again in 2 ways:


1)  Firstly for family members who desperately wanted their loved one to be admitted to a residential hospice as soon as possible.


2)  Secondly there were the residents (we never call them patients) and their family who didn't want their loved one to return home/nursing home/hospital when their condition plateaued. This sometimes would happen after the resident had been with us for typically 3 months or so.


The staff would be very gentle and sympathetic in explaining either of the two above scenarios but the people still understandably were upset.


Ontario has a mere fraction of the palliative beds that are needed to meet the full demand.


In order to meet the demand, typically the “stay” is looked at as a 3-month timeframe. Then the resident is re-assessed medically. 


This system is used to help meet the overwhelming demand for beds.


Also, there would always be a bed that would be available when an urgent case came up – someone who was quite close to dying.


The medical team would (among other things use a Palliative Performance Scale) to help them assess someone.  P.P.S. Palliative Performance Scale.  The following document provides other information regarding admissions:  Ontario Palliative Care Network

One way to look at it is this: If people were allowed to be admitted before 3 months and were allowed to stay longer than 3 months, then it would be very difficult to have a loved one admitted in a timely fashion because the beds would always be fully occupied.


I know that this is not a satisfactory explanation for anyone who desperately wants the best for their loved one. But this is the situation faced by many.


One thing to know is this: When people are admitted to a residential hospice, they will receive (in my 10 years of observation) the very best care imaginable.


It was always so poignant when a resident or their family would say, "I am so lucky to have come here!" It makes me tearfully humble to think, "Look at their situation! And they are calling themselves lucky?" Talk about helping someone put life into perspective.


I have learned so many "life lessons" over the ten years. Lessons about living - not lessons about dying. 


I wish you the very best.  Please remember, if you need to “talk” about anything in the future, come on back here.  We will be here for you.  - eKim

Réponse de Junior75
24 nov. 2021, 14 h 05

Thank you all for your input and suggestions.  Over the last day mum was not doing well so she has an assessement for a residental hospice this morning.  If that is not suitable she has been accepted into a retirement home under palliative care.  We are trying to avoid moving her too many times.  She is angry enough with her diagnosis and declining health I don't want to add to her stress any more than necessary.

I feel so lost some days.  Everyone says 'let me know how I can help' but its not that simple.  I'm an only child so no siblings for support.  My BF is always there for me, but again he can't do anything specific except listen.  All my energy is spent trying to find the best solution for my mum I haven't had much chance to process what is going on myself.  Reminding myself to take it one day at a time.
Réponse de Mary09
25 nov. 2021, 1 h 13

Hi Junior75,
How did the assessment go today?  I'm sorry this must be a difficult decision for you.  Is your dad around to help at all?  I am an only child also....I wish so much I had a brother or sister to help share all my struggles with mom with but it's not the case.  Mind you I know from experience that some people who do have siblings still end up caring for loved ones on their own because they don't get any help from their siblings... so I'm sure that's frustrating also.
Caring for someone at this stage is hard.  Theres no way to understand that until you've done it.  And to juggle it with whatever other responsibilities you have in your life is exhausting.  I find now I try to just take things one day at a time.  If I look ahead I'm either going to feel overwhelmed by how long I will feel like this or feel devastated by not having my mom here with me.  So just one day at a time.  Has your mom been living with cancer for a long time or is she recently diagnosed?  Mine has been fighting it for 20 years but it has finally started to move to different parts of her body.  I hope things with the hospice can be sorted out smoothly.  From what I've heard they are wonderful people.  
Thinking if you and sending prayers and strength.
Réponse de Junior75
25 nov. 2021, 13 h 18

Good Morning Mary09,

Mum's assessement was cancelled yesterday as the person was not feeling well.  I am hoping it will happen soon. On Monday when I saw my mum she was not doing well at all.  She was barely awake, struggling to feed herself, very lethargic.  Well yesterday she perked up and was letting everyone know how unhappy she was.  On the one hand I was grateful that she was feeling better but on the other it created a whole other stress level as I had to deal with the fallout of mum being very 'fiesty'.  I finally saw her late afternoon and had to reassure her that everyone is trying their very best to do the best thing for her.  Sigh.
Dad is not around, he passsed in 2019 after a long decline.  
Mum was diagnosed with her neuroendocrine tumour in 2018.  Her squamous cell cancer was diagnosed in December 2020.  She had radiation and immunotherapy but in September it was determined all tumours were growing so she decided to stop treatment.  That brings me to today.  I have a meeting at the hospital with mum, the doctor and the patient coordinator to try and get everyone (mum) on the same page with next steps. 

Sending you strength on your journey.
Réponse de Mary09
26 nov. 2021, 22 h 08

Hi Junior75,
How did your meeting go today?  I hope you were able to get things sorted out.  Is your mom resistant to going into hospice?  My mom would definitely be that way, same thing with a hospital.  We are trying our best to care for her at home but it is really hard.
Sorry to hear your dad sounds like he had a lot of health issues also.  Your moms health seems to have gotten worse very quickly.  I know you said you have no siblings (same as me)....are you married?  If not, do you have close friends or other family members for support?  I can only imagine losing both my parents, it would be heartbreaking.
I hope your mom was okay today and things went well.  My mom can be very "feisty" also, but I try to remember (although it hurts sometimes), that she says things out of anger towards her illness.  And that I can totally understand.
Bye for now,
Réponse de justlikefamily
25 févr. 2022, 4 h 29

Hi Junior75, I just got registered in this forum and saw your thread. I was just wondering how you are doing, and how is your mom? I hope everything is ok? Please let me know.
Take care!
Réponse de Junior75
25 févr. 2022, 15 h 40

Good Morning @justlikefamily and the group,

Thank you for you inquiry.  

After I made my post a bunch of things happened where my mum was concerned.  She was not eligilbe for hospice right away and she was moved to a retirement home temporarily.  That in itself is a whole other story and a complete nightmare.  She was in the retirement home for 2 weeks and was then finally moved to a hospice facility.   The Hospice was beautiful, warm, supportive, kind and compassionate.  We were so lucky for her to be there.  The sad part is that she was only there for 2 weeks.  My mum passed away on Christmas Eve.  I am thankful that for the time she was in hospice she was taken care of completely.  We were both treated like family.  I miss mum terribly.  I wish I had more time with her.  We always think we have more time but it will never be enough.

Sending my own support to everyone who is still navigating and caring for their loved ones.  Hold them close and love them hard.


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