Mitsy... what you said here surprises me. I am not sure what this doctor was thinking. Hospice is for palliative/comfort. Moaning is not something that would need hospital intervention. It is probably one of two things. It is either her way to communicate since she can no longer form words, or it is a sign of pain that she can not express.
The non verbal signs of pain include:
1) Facial grimicing- BIG CLUE, you know that little furrow in the brow?
2) Tense body language- They will stiffen due to the pain, clasp hands and shake, or shut their eyes and tense up. You may see their fist balled up.
3) Constant shifting in the bed. They can not seem to get comfortable because of the pain
4) Restlessness and agitation that can not be explained. As with number 3 it seems impossible for them to get comfortable and they become angry because it hurts. They may also guard the area of pain if it is localized so you can not touch it or they resist being moved because it hurts..
3) Moaning and/or groaning.
4)Combative with care. Think about it. You have someone who is very confused and they are hurting. You are going in to touch them or try to do care. They don't know who you are or what you are doing, all they know is that they hurt and you touching them hurts more. Worse, they can't SAY they hurt because they cannot articulate the sensation with words.
5) Elevated respirations/blood pressure/heart rate ALL indicate pain
In the late stages when Hospice is present, they need to treat the pain if there are any of the above symptoms. If that moan is accompanied by a calm relaxation then it is not pain. You can request that Mom not be transported to the hospital. I did this for Dad and have done it for Mom as well. They will have to present me with an overwhelming reason to transport her.
Lifts are only beneficial in certain situations when the patient can not help with transferring and they are too heavy to be lifted without hurting the care giver. The space should also be adequate for the lift to be used at all times. There are two kinds of lifts, a standing lift and a sling type lift. Each has it's upsides and downsides. I will say they are dangerous to use unless you have been taught the proper procedure. A better option is nothing more than a gait belt. It is a wide belt with a buckle that you use basically as a handle. It allows you more control over Mom while you are moving her. A physical therapist can show you how to use it in no time. Mom doesn't need to be able to stand up to help with transfer. There are techniques that can be used to safely transfer your Mom without a lift. Unless Mom is very heavy I would ask for a physical therapy consult to show the family how to do proper transfers instead of a lift.
Mom can be changed in bed as well. It is not necessary to take her to the bathroom unless she is still voiding in the toilet when she is taken. Again, a physical therapist can show you how to do this. While you are at it ask them how to change her linens by rolling her from one side to the other and changing half of the bed at a time.
Many don't know what question to ask. They assume that the professionals are giving them perfect advice. Nothing is perfect and they need to question what doesn't appear to be right. Sometimes they do need to get another opinion... and need to ask for that opinion. Hope this helped and bless you for trying to help this family