My 99-year-old mom is being removed from hospice because she no longer qualifies?!?

Don’t fret. I went thru similar situation. Call her doctor and tell them she complains of something whAtever she had in the past. He will write another letters get another hospice. They will do it.

Hospice is intended for persons with a terminal condition from which they will die within 6 months. That is true of all insurance companies and not unique to Medicare. (Think about it from an insurance perspective - why should any insurance company pay for "hospice" when the person does not have a terminal health condition?)

Simply being extremely old is not a qualifier for hospice. Medicare will pay for some in-home medical care for chronic health conditions, so you might investigate that.

My understanding of hospice is that they have to give you several weeks advance notice of "dropping" a patient from their services. You are allowed to "fight" the decision. You can get a doctor to intervene, get an additional evaluation from another hospice group, and if Medicare is really the culprit, you need to do whatever to get them on board to provide absolutely necessary care for your mom.

I'm so sorry for your losses (your dad and who your mom once was). This is all an extremely difficult time of life.

I agree with Bobby40 to contact your local Agency on Aging. Hopefully, they can point you in the right direction.

My dad was on hospice nearly 4 years after being diagnosed with prostate cancer that spread to other parts of his body (kidney, bone, etc.) We were told that it would likely be a speedy demise. No one can really say how long someone will live!

At one time, I was told that hospice was going to drop him. I immediately contacted a friend who was a hospice nurse for another company and she was able to evaluate and reassess his care needs. We hired her company and they came on board without us losing a day of hospice service. It was a great blessing, even though I didn't have the knowledge ahead of time how it would all work out.

Will Medicare pay for home health care?

I worked in hospice for a number of years and this is what is called 'graduating' when a patient no longer has a diagnoses of an end of life within six months. It would seem to me that your mother no longer has the medical problem that triggered the diagnosis for hospice. Unfortunately, there is no easy relief for you except finding a private pay help provider who can help. This, unlike the hospice which is under Medicare will carry a charge for you. The social worker at the hospice provider should be able to make a recommendation of some local providers. Alas, this is just one of the problems with healthcare in the US. We need an integrated system that is co-ordinated.

My father is also 99 living in an assisted living facility. Please check with your moms insurance to see what kind of in home care they may provide. With a doctors letter, they may provide at least a bath aide and maybe more depending on your moms medical needs. This is not hospice but can definitely be of help. Dad pays no co-pays for this service. He also has issues where he needs a nurse to come to him three days per week. This is also covered through his insurance. Definitely check this out.

Contact your local Area Agency on Aging - ASAP. They can often help provide in-home assistance at little or no cost. They can also direct you to other available resources.

Onthewing;

If YOU don't have help, you can't care for your mom properly.

Hospice is not MOSTLY for you; it's for the PROPER care of your mother.

Is it possible to tell your mother that it's really for the best to present with her true self to the medical professionals at this point and not to try to convince them that she's "all better"?

My mom and I had a thing; when we travel by air, I'd say "look pale". She was over 80 at the time and she needed special accommodations for TSA lines and an electric cart to get her across the very large Minneapolis airport. She wasn't going to get those by looking perky.

She would cooperatively list her head to one side and sigh as needed.

Fume seethe...

Right. Better now.

The medical director of the hospice service is asking the nurse for her assessment of your mother's condition - to be blunt, whether your mother is dying of heart failure or just experiencing the normal decline of extreme old age.

Line up the medical records you have, including especially those which were referred to for your mother's original hospice admission/approval. What do they say?

I am sorry for your loss. I am sure that this is a difficult time for you. You have not had much time to deal with the lost of your father just to turn around and be abandoned by hospice.

Under Madicare rules a pt must be at the end stage of their illness & it will only pay for 6 months, however, as you know people don't die on a time frame; therefore, Medicare will extend the hospice care on a month-to-month or for another 3 months if the pt meets their criteria. Yes, Medicare is known to pay up to a year or so. This means the pt must show signs of declining. Which your mom made not be showing at this time.
This doesn't mean she is not seriously ill. It just means that she may not be meeting Medicare requirements.
Some people for whatever reason will be on their death beds one minute and the next not showing any symptoms. Does this mean their better? "No" They are just asymptomatic (at the moment)!

CHF does not heal or get better on it's own. If she was dx with CHF and did not have treatment if it was possible than your mom is still very ill.

Appeal to Medcare! You will probably have to find away to get your mom to a cardiologist. Medcare will want proof that she is still 'going through her end stage'.

On another note: you state that your mom is afraid of dying, do you know why? Can you talk to her about it? Or maybe she needs permission to leave this world! I have seen where people hold on even when it looks as tho they shouldn't be (beyond medical reasoning), and the minute someone tells them that it is ok to leave, they pass on. Tell your mom she has nothing to fear and that your dad is waiting for her. Give her your permission to go! This doesn't mean she will just pass away but when she is ready 'she'll let go'.

May our God be with you and shine His light on your path to show you your way. May His grace, mercy, and peace cover you and your mom in this most difficult time in Jesus' name. Amen

I've been told that hospice will make a decision this week as to whether they will discontinue her. So it's not yet decided. However the nurse told me last week that the medical director is asking her questions as to whether my mim is dying of CHF or age decline. The nurse can't document symptoms at this point that show her deteriorating from heart failure and my mom always says she is doing fine when she isnt. She has a way of putting on for others...but my husband and i see her at her worse. Her dx from the doctor is CHF...and I don't think that goes away on it's on. It's just not presenting as her dying right now. My Dad had clear symptoms and was a classic hospice death....
I feel like I want to advocate for her but honestly it may be mostly for me?

Also, determining that the CHF has somehow cured itself because the lady isn't showing symptoms is nonsensical. If she is sitting still and well supported, in a recliner or with her feet on a footstool, then she isn't going to be breathless and there won't be any oedema so's you'd notice. Doesn't mean her heart function is any better than it was.

My mother used to tell people that she wasn't ill because her symptoms were well-controlled. In her case it was pride and denial, but I'd expect a hospice team to have a better understanding.

I had the same thought: appeal. There must be an appeal process. Your mom's CHF has stabilized most likely from the excellent care she was regularly given from hospice.

How awful to have this happen as you process the loss of your father. You can appeal Medicare's decision. It would be helpful to have your mom's doctor weigh in as well.
Don't try to do this alone. Get help even if you have to pay for it yourselves.

I'm so sorry for your loss of your father, and for what you're going through now.

First of all, take deep breaths. Your father's passing means that at the moment you are going through a crisis. Just when you need time and calm to adjust, you find that the support for your mother has been called into question.

Have the hospice services for your mother already been withdrawn, or has this just been mentioned as a possibility?