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Carol Bradley Bursack, Published March 17 2012

Bradley Bursack: Daughter asks, 'When should we call hospice?'

Dear Carol: My 87-year-old mother has Alzheimer’s disease. She came down with shingles a few weeks ago, which is being treated, but she’s still in terrible pain. She also has COPD and diabetes.

Since the shingles attack, she has gotten very weak and just wants to sleep. She only eats if we feed her, and then she has to be coaxed to eat even a small amount. The family has been taking turns staying with her, but she mainly wants to sleep.

Should we call hospice?

When do people decide it’s the right time to call? Does the doctor contact hospice or do we? Her doctor hasn’t mentioned hospice, but he says she likely will continue to get weaker. – Melanie

Dear Melanie: Shingles can cause extreme pain that may linger for a long time. For some people, the pain becomes a nerve condition that never goes away. Your mother is 87 years old and has several significant health problems. Add the pain from shingles to the mix and it’s no wonder that she is weak and has little appetite. Her need to sleep most of the time could be physical, emotional or both. Sometimes sleep is a way to withdraw from life.

Hospice provides palliative care, which is meant to keep the patient comfortable if there’s no cure for their condition. Many doctors don’t want to bring up hospice care with family members out of concern that the family will think they are giving up on the patient. Yet, when asked, most doctors will inform you about hospice care and do their part to help you arrange the care if the patient qualifies. The criteria used for qualification is generally that the patient is considered terminal with likely six months or less to live. An 87-year-old woman who is as weak as your mom, with her host of health problems and little appetite, is likely to qualify for hospice care.

Your mom’s health could improve under hospice care, and then she would go off of the program. This happens more than people realize. I’d encourage you to talk with her doctor about some type of comfort care. You may also want to call your local hospice organization or, if you have more than one in your community, call several. They will answer your questions. My experience with hospice is that they are caring professionals who work hard to help incurably ill people live the best quality of life they can, up until their natural deaths.

If you have friends who have used hospice care for their loved ones, you may want to talk with them. Accepting impending death is never easy, but with compassionate care, which hospice extends to the family as well, you will get through this.


Carol Bradley Bursack is the author of a support book on caregiving and runs a website supporting caregivers at www.mindingourelders.com. She can be reached at carol@mindingourelders.com.