80 yo widow of 3 months with 6 living children, 1 living with her and another just down the road, has been diagnosed with Stage 4 adenocarcinoma of the lung. The primary is 6.5x4.8x4.6 cm, upper left lobe, with some effect on lingular segmental bronchus and other segmental bronchi; one met at T-3; she does not remember about lymph nodes. Cancer was discovered accidentally; she feels fine. EGFR and Alk-1 are pending.
She has gone to the beach for the week, given that there is nothing she can do but wait, so it might as well be pleasant. We (the kids, of whom I am the oldest) are to look into hospice while she is off to the ocean. I am sure that what we should ask providers depends on what we want them to provide. However, having the staging for just over an hour, we are not really sure what we are looking for. My father's death did not involve hospice. He had a slow decline into dementia, requiring nursing home care for the last 3 months of life. As a family, we worked hard - and were pleased with the result - to keep him at home. We moved him to a nursing home only when he became a danger to self and others because of violence. The house in fact is already partially modified for home health care.
The general plan that we have now is to set up a relationship with a hospice provider, even though no services are yet needed. Once she does need care, we will go as far as we can with hospice at home, knowing that sometimes the last week to 10 days may require a facility, just depending on how her course goes. There are over a dozen providers in her city - how do we choose?