Explain a little about Hospice. My aunt will be in hospice in an assisted living. She is not bed ridden yet?

She is going from a re hab facility back to her assisted living on Friday. We got Hospice because while in rehab for the PT her miedical conditions have worsened. Kidney failure is getting worse and if she would have wanted dialysis, it would be the time At 90, she said NO. She has bone cancer, but no pain (yet) and a diabetic. She does not want to be on all these meds, no dialysis, and just wants to let nature take its course. As a niece, and caretaker, right now she does not need 24/7 care, but if on Hospice what will they expect of me and husband as it get worse. Right now, will we have to be there more than short visits everyday like before her hospital stay? She has lots of assistance at this faciltiy now.

My aunt (who was also 90) was in an assisted living facility. The care she got from the hospice nurses was a MUCH better quality than the assisted living place provided. They looked after all her needs. Did laundry, fixed simple meals, sat with her when we couldn't be there, read to her, etc. The down side (that no one mentioned before hand) was that in our state, once she went on the hospice program, medicare stopped paying anything towards doctor bills etc.
We're sending all our good thoughts to you and your aunt. Hospice will be a big help and comfort to her. And a much needed break for you.

i'm assuming she's going to a hospice facility where a hospice nurse will do all the work to make her as comfortable as possible...

your role is to be there for your aunt as she dies...however way you see fit to do that.

Hospice provides care for adult and pediatric patients with a wide range of life-limiting illnesses.

They provide Palliative Care鈥攖he aggressive treatment of physical and emotional pain and symptoms. Palliative care is an active treatment plan, but is not intended to cure a patient鈥檚 underlying disease. Palliative treatments focus on enhancing a patient鈥檚 comfort and overall quality of life.

The nurses are skilled in assessing and managing pain; they are trained caregivers who provide hands-on care.
they have social workers who are available as friendly and skilled listeners to help provide emotional support and to help with financial issues and planning.
Their physician works with the patient鈥檚 physician and is available for pain and symptom management consultation as well as to make house calls, as needed.
A home health aide is available to help with personal care, such as bathing or dental and mouth care, and also can help with light cleaning, light laundry and occasional shopping.

They have bereavement specialists provide grief and loss counseling, memorial services and other support for family and loved ones.
If, at some point, a patient needs more constant care, they can provide shifts of hospice staff for a brief period to help the patient through this demanding time at home, rather than transferring the patient to a hospital.
They also provide hospice care to residents of Long Term Care . Facilities and Nursing Homes, Assisted Living Facilities and Residential Care Facilities for the Elderly .

My first suggestion would be to talk with your hospice team social worker about facilitating a meeting between you, your aunt, the hospice nurse, as well as a representative from the ALF. This might be a helpful step in figuring out how much assistance your aunt will be able to get from ALF staff and the hospice team as she declines. Depending upon how much assistance she needs as her disease progresses, you might need to hire a caregiver (or caregivers) to help your aunt, unless you and/or ALF staff can be present to give meds, do position changes, change diapers, etc. The period of time when your aunt will need nearly total or total care might be very short and intense, or could stretch out for a long time. Unfortunately, it's very hard to predict the direction her disease will take. That's why it's important to be proactive and get to know the hospice team now and use them for advice, advocacy, support and information. They should be able to advise you of the care options available in your aunt's community, and they should be able to support her care with appropriate medical equipment, medications, education of facility staff and family, and emotional support to both her and you. If they don't meet your expectations, don't sit with it, speak up and be willing to take your business elsewhere if need be.

In my experience, ALFs are often not able to provide adequate care to patients who become bedbound, and/or who need frequent assessments of their pain and symptoms. Again, this might mean hiring caregivers, or even transfer to a nursing home or hospice facility.

Good luck.