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My 93 year old father has dementia and is resistant to help in any way to begin with. We have seen him benefit from nebullizer and oxygen treatments when he was on hospice. He is now on another hospice and it isn't their policy to administer these things, we would have to give them to my father.

Any advise or tips on doing this when the patient is resistant?

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This is a difficult one and I feel for you. As a hospice caregiver in the past I have felt that suffering as I listened to a patient try to breathe. As a 75-year-old with breathing issues that have reduced me to the point of blacking out, I can tell you that the patient is NOT having the same experience as you are. You don't say what happens when he appears to need oxygen, so I don't know if somewhere in his brain he knows that oxygen will prolong a life he is ready to leave. (This was my case.) Or perhaps he gasps and struggles, thinking an oxygen mask will prevent him from getting air into his lungs. That your father has been referred to Hospice means his time has come; for his sake, try to maintain your own calm and steady breathing. I am sorry I can't specifically answer your question which has been posted unanswered all day. There may be no easy answer to this. I can only say, regardless of how your father is behaving, it's impossible for you to know how he is feeling. Blessings.
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Skip the mouthpiece if he is on that, that is just silly. Get an aerosol face mask nebulizer, you can just slip it over his face and he doesn;t have to hold it.
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not sure about the previous hospice being an option. I had thought about it. This one has alot of pluses, all except for them not doing the treatments. Apparently it's against all hospice policies with the home health aides for liability reasons. But the last hospice was doing it with no problem and it seemed like just a part of their routine. So we were baffled to find out that it's not typical for hospice to administer it, they consider it to be something the family needs to do. What his neighbor has been doing is holds the neb. piece close to him while he is sleeping, about 15 minutes. He has angels for neighbors.
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If your father is in hospice, do you not understand that he will die shortly? It does not matter whether he gets oxygen or not, as his diagnosis by his doctor has deemed him incurable. Leave him alone to be who he is right now. And I will pray he has a peaceful death.
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It's easy to confuse the delirium with a need for oxygen. Adding oxygen when the patient is close to the end, won't help the delirium. Morphine would be the better choice to make him comfortable. You will see more confusion and agitation in the last 24-48 hrs. Up the morphine and deploy the Ativan every 4 hours when this happens. Talk to your Hospice Nurse, call her anytime you feel your own panic coming on.
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If your dad struggles and is in discomfort when he's on oxygen or the nebulizer, but peaceful when he's not, then there doesn't seem to be a good reason to do the treatments.
If, however, the reverse is true, you could try holding the nebulizer mist near his mouth and nose (if he does not want to use the pipe) to give him some of the benefit from it.
However, what sounds to family members like difficulty with breathing is usually just a part of the natural process of dying. Interrupting it with interventions can actually create suffering. The nurses at hospice should be able to help your family sort out what symptoms are natural and what symptoms indicate that support is needed.
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You're asking people to give you ideas as to how to circumvent your current hospice rules. I believe there are many aspects of hospice, including chaplains who can help you through this very hurtful time of life, i.e., death. We don't 'see' death often, but when we do, we become conscious of the dying process and for the most part, you can't sanitize it. Hospice is not trying to hurt your loved one, they are doing what they do best, allow a good death. Please talk to the people who are actually caring for your dad through this process. I wish you well.
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He isn't really having breathing issues so much as we noticed that giving the neb. and oxygen treatments in the past gave him more energy and he seemed to be able to think better. He has dementia and heart problems so it makes sense to us that oxygen helps his heart to pump better and get more oxygen to his brain.

Hospice doesn't have a problem with us doing this, it does help with his quality of life but this latest hospice will not administer it for us. Whereas the last hospice did do it for us.
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It's not as cut and dry with my dad as far as how close to the end he is. It's like the hospice nurse said to me, that it's easy for them to gauge when there is terminal cancer but when it's dementia and the heart there isn't always as easy to tell. He still has life left in him, he just has strong genes or something.

A neighbor has been doing what you suggested isn'tEasy the last few days. I guess that is the best way to do it.

It's hard when someone has dementia and you know they aren't making the best decisions for themselves.

He was getting neb and oxygen treatments 5 days a week with the last hospice and he improved to the point where he was released from that hospice and I know it was all because of the neb and oxygen treatments. It's a shame.
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Sandy, is returning to the previous hospice facility an option?
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