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My brother, an m.d. and the DPOA of my mother's healthcare, recently pushed to enroll my mother in hospice. There is no known terminal diagnosis and when I ask my brother what the diagnosis is he remains silent. My mother has periods of lucidity as well as confusion since she had a laminectomy under general anesthesia. How can I find out what the specific diagnosis is that qualifies my mother for hospice?

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My mom had hospice 2 years ago. She was really sick and she has dementia on top of that. I am so glad she was enrolled. She got alot of attention and alot of extra help and she improved . It happens. Of course , when she improved she was not longer considered a candidate for hospice. For now, she is stable but at the age of 91, things can change overnight.
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Also as family, hospice benefits are available to YOU to help you understand and deal with your mother's condition. So in that sense, you should soon know what is going on.
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I went to the doctor with my Dad and the Dr diagnosed that he has atrophy brain damage and it is progressing. No death diagnosis. He did confide that if it were him i my Dad's spot, if he were happy but not lucid, fine, but if he were not lucid and became unhappy or one of these old mean grumpy guys with dementia, he would want to be enrolled in hospice (don't forget hospice is a process, not a place, you can be "in hospice" at home) rather than having surgeries or procedures to correct whatever illnesses befall him as he gets older. In other words, if he were miserable, he would not want to be supported to live that way. So that is what an MD thinks of hospice. My Mom went into hospice,me thinking she had months, went home to pack, and she died while I was gone. Hospice would have been great sooner. It did her no good waiting that long, and we are all still suffering. Don't wait, if hospice is suggested, it can only help. IMO.
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Hugs...
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Answered prayers...hugs to you for sharing at this difficult time!
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So sorry Manis glad you and your brother are unified..
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I am very sorry for your loss manis, but I'm glad that you and your brother were able to work through this! ((((HUGS))))
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Manis, that is such very good news.
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My brother and I have resolved things and were unified when she passed.
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Condolences on the loss of your mother.

I hope that knowing the hospice placement was appropriate will be of some comfort to you. I also hope that in the coming year you can reestablish some meaningful relationships with your brothers. This has been a sad ordeal for all of you.
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Manis, I'm so sorry for your loss. It may have been your Mother's wish for her diagnosis to have been kept secret, and you will never know the reason why. Perhaps in time your brother will provide you with an explanation, but now is the time to unite as a family and help one another to grieve your loss together. She is now your Angel, and will always be with you in spirit!
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Very sorry for your loss. My hope is that you can put your differences aside with your brother he is family. If you can make peace it will go a long way toward healing. Pleàse know that others care.
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So sorry - and now that you have found out, it seems very possible that the right things were done. There is not much that can be done for someone with dysphagia in the setting of advanced dementia that helps increase either quality or quantity of life. I'm praying for your comfort and for the family to be able and grieve together in a way that mends the hurts. I am sure you will miss her, and hope you have some better memories to comfort you too!! Hugs...
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thank you
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Dear Manis, I'm so sorry for the loss of your mother.
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For a person to qualify for hospice and for medicare to pay for the services a patient must be certified by a doctor as having less than 6 months to live and a specific cause must be cited with evidence. In my mom's case I finally found out that her diagnosis was dementia with trouble swallowing. After getting another one of her chronic uti's last week my mother went downhill quickly and passed away.
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Please make sure that your mom had the legal capacity and was competent to sign the DPOA document at the time it was signed. The definition of legal competency is that your mom understood and comprehended the consequences of the actions surrounded by signing this document. You might also might to contact Medicare or QID if you have a reasonable suspicion that medical abuse is taking place. They will probably investigate the case if you have reported a good faith case and have the facts in order including the time, place and manner of the signing of the DPOA. Affidavits or a written report from the doctors, nurses, laymen or others that your mom was not competent when she signed the DPOA would greatly increase the odds of Medicare investigating the competency of your mom when she signed the DPOA and the probability of health care abuse. I realize that this will take a considerable matter of time to gather all of the above but you might need this information at another time such as when and if your passes. Good Luck and God Bless.
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The OP states that even now her mother has "periods of lucidity." It would be just about impossible to prove at this time that she wasn't lucid when she signed the document. There is a huge gap between a doctor diagnosing dementia and a doctor declaring someone incompetent to make decisions. (It is ultimately a court that makes that decision, in any case.)

It is the hospice doctor who determines the eligibility for hospice, often with consulting the primary care doctor.
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My mothers doctor said that just because a person is "forgetful" in the beginning years of dementia, it doesnt mean that they cannot make decisions. Its further into the diagnosis down the road when their reasoning goes. I have never read of anyone reversing a POA has anyone else? But if someone wants to spend their money to try, hey why not. I never said "not to" I stated using APS is free and may help her more without robbing her.
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As long as I live - or maybe I should rephrase to: as long as my mother lives; I am her DPOA both financial and medical - I will NEVER understand all this secrecy crap! I am a self confessed control freak. I have a very volatile relationship with 1 of 2 brothers - yet I tell and show my brothers anything they ask about. Sometimes when something is particularly difficult medically I call them. What is the problem? I just don't get it! In truth I don't give my brothers passwords to access finances but that's just common sense - they are free to look at statements anytime they want to come on over. Am I the exception or the rule?
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~ If your brother signed the orders, as a doctor, to put your mother in a hospice, isn't it a conflict of interest, for him to be his mother's doctor?
I thought relatives, (that are doctors), can not treat family members?
What happened to the doctor that has been treating her, in the past?
I don't know if there's any legal standing, regarding this .... Something you might want to look into.
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I'm sorry "Reverseroles", but you're wrong in advising her NOT to look into her mother's state of mind, when she signed the POA.

What she has to do is, get records from her mother's doctor that states, the earliest dates of her diagnosis as to when the change in her mental health started. Also, get some follow-up records, showing it's progression. Compare these dates, to when she signed the POA.

DON'T go directly to the lawyer ... Of course he's not going to jeopardize his reputation. Adult Protective Services (APS) may be able to help you with this.

I don't know what your brother is up to, but there's obviously a reason, he's being so secretive. I also don't know what state "manis1954" is from, but I've been through this with two families I cared for, in both NY and FL. It split the family in half ... The POA in both instances was up to no good. The one POA, (in FL) wasn't even related to the person, and does this as a career.

Good Luck and God Bless.
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Exactly megan, that would be a lawyer admitting he was wrong, no way!
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Some people when give the DPOA use it as a status symbol and become control freaks! It's nearly impossible to get that special power taken away from them unless the patient does it. Don't believe the lawyers who will tell you they can do it b/c is the end you end up paying thousands and thousands of dollars for nothing. Our lawyer advised us there was no guarantee and he was right. We spent alot of $$$$ to learn the lesson. The headache and heartache are not worth it.
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I went to a seminar on Hospice 5 years ago. It was to explain to people that it isnt just for end of life anymore. My mom was determined eligible at that time but i waited. Got it 2 years ago and they were no help as shes a 2 person assist and they couldn't find an aide to turn her. Okay now my moms 94 going on 95 and could get hospice again but i wont get unless she is dying and needs morphine.They re-write their care plan every 6 months. They said people can be on it sometimes 2+ years because they need support and no one really knows when an alz person will die. So it doesnt mean she is dying. Why wont your brother tell you? You can call the adult protective services and they will investigate free. If he is using her money or keeping her from seeing you, they can take care of that too. Now, as far as her signing a POA while not in her right mind, forget that one. NO lawyer us going to say she signed it being incompetent because his reputation is on the line! Even if she was, the lawyer would NEVER admit it! know what I mean jellybean?
Good luck!
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Thanks, ff.

manis1954, from your other posts, it looks like your relationship with your brothers is dysfunctional. I am so sorry. In previous posts you were given a lot of advice about pursuing a change in POA and/or consulting a lawyer, to bring you mother to live closer to you. Did you follow up on any of that advice? What was the outcome?

In any case, my previous answer on this thread stands. I do feel sympathetic to your situation. Talk to hospice personnel. Continue with a loving relationship with Mom.
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manis, if you have time could you go back through your prior postings and answer some of the questions that the writers presented? Such as why did your Mom, at 92, have a laminectomy surgery on her back? After surgery did she go to rehab, if not, why not?

Please note that in order to go into Hospice your Mom had to be referred by a doctor [maybe your brother] but there is also a Hospice physician assigned to the Hospice group, and he/she also makes the call if someone is ready for Hospice.

Surgery is very difficult for an elder, it can send them into delirium and/or worsen dementia. Yes, there will be time when the elder sounds clear and alert, but that comes and goes.

Manis, are you a son or daughter? There are times when a woman your Mom's age doesn't want a son to know her medical condition if the condition is female in nature.
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To find more information about manis1954's situation. Go to the SEARCH BOX at the top right of this page and type in manis1954. A list will appear with prior questions that manis had asked.
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For a patient to qualify for hospice they have to have less than 6 months to live. Medicare has special criteria and won't pay if your mom does not meet the criteria. Your brother should not be hiding this info from you. My brother wont tell us anything about my mom. It infuriates us but I do know he will have to live with this guilt the rest of his life.
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Retain an attorney. He'll have to talk to the atty or be in contempt!
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