How does Hospice fit in with other services?

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My husband is receiving in-home help in the form of a PCA for a certain number of hours a week, and also homemaking services once a week, through Elderly Waiver. When the time comes for Hospice, will those services continue, or be replaced by hospice care?

Answers 1 to 10 of 23
Anyone have any experience with this?
Jeanne, I'm Hospice volunteer & Suncoast Hospice will honor all your & your husband's wishes. If you want PCA services to continue they will - My name's Karen & I live in Pinellas County, Florida, so I know a lot about Hospice.
Top Answer
Jeanne, I just stopped Hospice and although you hear good things, there is just as many bad things more than I will mention here. I think in the very very end they might be okay? My Mom is non verbal, 90, and according to the doctors, severe dementia or alz, they cannot tell for sure. She cannot walk and I puree her foods and use thick-it. In desperation I called Hospice several times after a seminar I went to, no one had mornings available. Mornings are horrible for me and then I am okay. Finally after calling the best rated Hospice again and was told that just hired two HHA's and they guaranteed me they had every morning available. On our 4+ hour intake interview at my house I was told they are experts, can hoyer Mom, roll her, bathe her and get her ready for the day in 1 hour. I explained to her all of the problems I have with the hoyer and I cannot roll her as she resists. Long story short, day one a HHA came and she couldnt roll her, nor get the hoyer to pick Mom out of bed without being on a curve making it impossible to get her into her wheelchair. Day 2, they send another HHA who also had the same hoyer problem and pushed Mom real hard to roll her whacking Moms hand against the wall twice as soon as I walked out of the room both times to get a towel and throw away her diaper. Needless to say I give anyone many chances, and I am here to help. Day 3 Hospice is due at 830am and the phone rings telling me the HHA hurt her back and will be out 2 weeks and they are not sure who they can get now as she thinks Mom is too difficult a case. They then offered me help for 1 hour about 2 or 3pm occasionally(moms nap time) My only problem is mornings, I stressed that before I signed. Once Moms up in her chair, I am set other than lifting on and off the toilet for bathing.
The nurse who did the intake was so nice, she came over and said "I am coming back to you with my tail between her legs." She explained Hospice is supplemental, they come when they can, and if they dont have anyone, they dont come. She said Mom is a 2 person assist and most at her stage are in a nursing home, although I am here to help but I need a strong person. (My husband and I can roll her together to get her hoyer sling off at bedtime but he leaves at 5am for work)
I am not knocking Hospice here, just want to tell you my story and I am sure others will. I signed out of Hospice and hired my part time CNA every morning, she is fabulous and I am broke, lol.
After I signed up in the beginning, the Nurse said to me "now dont call the ambulance or go to the hospital or doctors and dont buy any medication , call us for everything day or night and we will mail you a medication kit to not open "unless we tell you." (it never came)
WHAT? When I called originally and asked I was told I could still do all of those things, but guess what, if you do, you pay. From Hospice on, you are dependent on them and cannot use medicare for coverage unless they approve. I am glad I am out of it and when I signed out, she asked, "and who do you want her doctor to be now?" I was shocked, as Moms been to the same doctor for over 20 years, to think they removed that priviledge even temporarily erks me.
Since then I talked to a friend I met at daycare years ago and her Mom also had Hospice, she said there were days Mom wasnt ever changed and they were to change her daily at the center as she was in a reclining wheelchair all day and a 2 person assist also. A long time friend just had her husband pass away in a Nursing Home of cancer 2 weeks ago, she told me when her husband needed morphine they had to "call" Hospice and it was hours before anyone could come, she was furious and wish she never signed on. Finally Hospice gave the Nursing Home the authority to give that Morphine for them as they had no one available.
So, as far as other services, make sure you know these things and dont let them fool you. Yes you can call and ambulance and go to the hospital and your doctor but you will pay for it out of pocket.Yes they will send an Aide, but when they want to. I hope this helps and please no one take offense. I decided to do things without them and use moms doctor and be in charge, not having them call the shots for my Mom. Hope some of this helps you.
PS Hospice had diapers sent to me, they were so thin Mom wet through them, her pjs, her disposible bed pads , regular bed pad, right onto the mattress pad. The chux they sent didnt hold up. The day after I signed off I got a call at 8am wanting her hoyer sling back and they were coming to pick it up. amazing. If you think their products will save you money, they will not, you still need to buy your own if you want to keep him and his bed dry. I found the Tena diapers are the best and I add a Tena pad at night . I cut slits in the back of the tena pad so it all absorbs into the diaper and doesnt roll off the edges due to the plastic backing. I guess what I am saying to you Jeanne is, if what you are doing now is working, I wouldnt change things unless you absolutely needed to.
similar to task 4. for usa vein clinics offices (9 in total in different states). add comments to all of them. if some locations missing, add them using info we have on google local pages.
I used Hospice services for about 3 months and was very pleased with their attention to my wife, the patient. Also they had literature that helped me better understand the dying process. Eventually I discharged Hospice when I was able to care for my wife myself, but there was something that bothered me. When I expressed concern about who paid for Hospice I was simply told it was all covered, "You won't be billed . . . don't worry." But I did worry. Later I found out that Hospice submitted very substantial bills to Medicare without sending me copies. I don't know whether these payments will affect other services that may be paid for by Medicare in the future, but being left in the dark about billing is not good. It leaves speculation as to why . . . and speculation is not good..
Dirk, I was told by reliable source that the hospice we use for my dad charges $10,000 a month! Now I know we don't get $10,000 worth even though they cover his meds, hoyer, bed, oxygen, other aparatus, diapers, pads, interal feedings, 2 nurse visits a week, plus right now CNA visits 5 days a week to bath him (this is recent, before it was 3 days) If only he could get this coverage outside hospice for Drs and specialized care! I guess there is good and bad to everything. My dad has been on hospice for 11 months now...I can only imagine the bill. Best of luck to all in this very difficult decision for loved one, it is a good service, no complaints, not perfect but what in life is?
Hospice is an entitlement benefit under Medicare for citizens who qualify for Medicare. Hospice has several levels of care from the base level through to general inpatient where symptoms are out of control requiring constant review and management. Under this general inpatient level of care an RN has to be on hand 24/7 so it is really in a facility. Continuous care is also available where approrpiate but need not be conducted by an RN, although the case manager is (or should be a nurse). There are requirements and you can google these - they are called Conditions of Participation (COPS) and these spell out what is required of a hospice provider. Typically they cover a base line of care and most hospices exceed that level of care whenever it is needed by the patient. Hospices bill direct to the payer (Medicare mostly) for hospice care and all care for the admitting problem (diagnoses) are covered. So unless you are paying yourself, and if you have Medicare coverage, there really should be no bill from the hospice. If the hospice bills over the amount then the bill will not be paid by Medicare and the hospice queried.
We all pay for Meeicare during our working lives and 2.9% of salary, 1.49% from our pay check and the same from our employer goes to Medicare to cover costs. So that's why its an entitlement, you have previously paid the bill

Yes you shouldn't pay anything IF you let them do everything, don't go to the emergency room, or call an ambulance or go to a doctor. It's paid if you let them do it all, they are in charge now, not you.
I don't understand what you mean by "they are in charge now, not you."

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