In Inpatient Hospice

As of Saturday morning, Ed will officially be a hospice patient. I chose inpatient hospice at Grant Hospital, so he doesn't have to move an inch, just stay in his same hospital room. He will still have care from the floor staff, but in addition, the hospice nurses and other staff will be seeing him, reviewing his situation, revising his medication needs based on what will keep him most comfortable. In other words, he will be getting lots of attention and consideration. Today he was lucid, able to talk with us, recognize that his family was there and even called me by name and hugged me, understand what was being said to him, though not able to identify where he was. Dr. Mitchell says although that looks to us like he's better, the fact is this is typical of the last days of a kidney cancer patient--kind of like a wave of little ups followed by bigger downs, with the trend being all downhill. Ed has already shown some of the signs of being in his final days, like yesterday's constant fiddling with the bed linens. Today he kept taking off his hospital gown until we finally left it off him and eventually got him into his own undershirt once the IV fluids were removed. (They were removed because continuing them would build up fluid in his lungs.) He frequently has rattles when he breathes as he rests. These things are signs of the diminishing of oxygen to various parts of the body as it prepares to shut down. On average, patients stay in inpatient hospice care 5 to 7 days. We were able to have inpatient hospice because I am in what is called "caregiver's crisis" because of my current back problems. After a week or so, a decision must be made again based on medical condition (his and mine) to either bring him home with hospice care (which is not all that extensive, with me, the caregiver, having most of the work to care for him at home with whatever extra help I can arrange) or, if he has only a little time left, take him to Kobacker House, a hospice house where people can spend their last few days, or take him to a skilled nursing facility where his same hospice team will look after him along with the staff there. So the decision-making is not necessarily over with, but I feel I made the right choice for right now. We would have preferred having him come home, but it just isn't possible for me to do that right now. I'm sure he understands that.
Joni