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At-home hospice is covered by Medicare.
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My late husband was under hospice care in our home for the last 22 months of his life and his Medicare covered EVERYTHING from equipment needed, supplies, all medications, a nurse coming once a week to start, and aides twice a week to bathe 100%. I didn't pay one penny for anything.
But keep in mind that even though they cover everything, you still will be doing 99% of the work/care, as a nurse coming once a week and aides coming to bathe twice a week are really not all that much help in the big picture of things.
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My mother's home health aid was covered when she was in hospice. Lovely woman that would wash Mom's hair or sit 'n chat or have a meal with. I did the laundry and ran the vaccuum cleaner in her room as Mom was living with us. Otherwise, Mom's time in hospice was the least amount of caregiving I had to do.
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funkygrandma59 Feb 2023
Ariadnee, where do you live that hospice covered a health aide to come have a meal with your mom? I've never heard of such a thing.
Yes, they send aides out a couple times of week to bathe the patient, but to "sit and chat or have a meal with," unheard of.
I know that hospice has volunteers that will come visit a patient for a short time, but they are only there to visit.
I had to hire an aide to come 7 days a week to put my husband on the bedside commode so he could poop. And like I said in my initial response on this post, 99% of my husbands care was still on me while hospice was involved, right up until his death.
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Hospice is completely covered by medicare. However Hospice (TODAY ) does very little. They will send all the equipment including hospital bed, free. They send out an RN once a week for about an hour and basically she sits at the bedside and talks. They will leave the magic med of a little morphine bottle and some few other needed meds. They will send an aid two or three times a week for a bath. They will have a clergy person call and a social worker, who if like the last I met when my friend died recently, won't know much about anything. And for that the government pays a lot. They have become Hedge Funds darlings. They are money makers.
The other problem is that Hospice will not care for the patient in home if the patient needs and doesn't have 24/7 care, and there's the rub. That can be family or anyone else but if there is no family as was the case for my friend, then you are paying a whole lot of money for even a sitter. My friend had two women who did 12 hour shifts at 20.00 an hour (cheap at that) until she died. Figure out the daily cost on that.
So that basically is hospice today. If the doctor will order hospice for you or for the loved one you are writing about then interview them and have your questions lined up. As bad as they have become compared to what Hospice once was they are the best we have for pain free final exit, and thus to be treasured so long as we are able to keep them.
If you have more specific questions, do ask them and hopefully someone here can help.
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TeethGrinder65 Mar 2023
95% of hospice in the US is home hospice. Most patients prefer to die at home. In my state, there is one facility with about 50 beds that provides round the clock care. There are numerous hospitals that provide in-house palliative care.

The fault of those costs lies with our dear health care system and the profiteering insurance companies. THEY are the ones who decide what gets covered and what doesn't. Then there's the way our society prioritizes the elderly (that is, not at all).

I'm a hospice volunteer, AlvaDeer, and I have to say, reading your post got my cockles up. I don't get paid, I give my energy and time to strangers to help them at a difficult, sad time. The CNAs and nurses (and all the others) are called to this work, not randomly assigned. We do this because we believe in the program. No, home hospice doesn't do everything. But we do a lot, and most people who turn to home hospice are grateful and wish only they had done it earlier.
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For mom, hospice has been helpful. She needed a qualifying diagnosis from her doctor to be admitted to hospice care. There is no charge to mom because Medicare covers it. In addition to the hospital bed, they supply all mom's incontinence supplies: pullups and diapers, wipes, ointments, perineal cleanser, gloves, masks, waterproof pads, body wash, shampoo, nutritional drinks. They supply all medications to keep her comfortable including her blood pressure meds. They deliver it all to my door. The bath aide takes care of the shower twice a week and does a skin check for pressure sores. At least I don't have to worry about these things. The nurses check her vitals and her skin too. The social worker guided me on preplanning funeral arrangements and establishing end if life choices. The day in day out care and feeding still falls on me, so there's still alot of work to do but at least I don't have to worry about paying for all those supplies and the aide. It has given me peace of mind knowing everything is planned and taken care of. And if mom needs anything, or if she falls, or has unusual behavior, hospice us available 24hours to call for advice or help. If you go in realistically with your eyes open to what help you will receive it may work for you.
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The Cost of Hospice is covered by Medicare, Medicaid and most all other insurance.
The visit by the Nurse, CNA, Social Worker, Chaplain and any "therapies" are all covered as are supplies, equipment and medications.
BUT...They are not there 24/7/365.
It is best if you have help. A paid caregiver or family member that can help out a few days a week for 4-6 hours minimum.
Hospice can provide a Volunteer that can come 1 time a week for a maximum of 4 hours. But they can not do any "hands on care" so no feeding, toileting, changing the patient.
A GREAT benefit of Hospice is that Medicare, Medicaid will cover the cost of almost 1 week of Respite care each year. So you can get away, get a break or take care of other family emergencies that may come up.

I would not have been able to keep my Husband at home if I had not had Hospice in.
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As others have mentioned, hospice is paid by Medicare but the day to day care falls on the family. When my mom was on hospice, I hired private care to stay with her at night so I could rest and I took the day shift. My mom did not live long after engaging hospice so the hired care cost was limited. Had she lived longer (and I wish she had) I would not have been able to afford the private care for long. Hospice was invaluable with supplies, bed, medication and an on call nurse when mom started to actively die.

I wish you comfort and peace through this journey.
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WeAreTrying Mar 2023
Name of the over night privet care company? are they national?
Looking for options.
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My wife receives in-home hospice care and even though I am still the primary caregiver it is a big help.
A nurse only comes in once a week; however, they are on call 24/7 so I do not have to worry about doctors' visits, emergency rooms or Urgent care visits.
They also handle all of my wife's medications.
It is a big help that an aide comes in twice a week and takes care of showering, hair washing and overall freshening up.
I do have a caregiver come in 3 times a week for 4-6 hours so that I can get out on the golf course.
The caregiver is my cost at about $20/hr but she makes a big difference in my health and quality of life.
I am so glad my caregiver pointed me in the right direction to find hospice.

Jamie
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Hello from a hospice volunteer here, Gillyrich. Most of what others have said is true. Home hospice is a support service, not 24 hour care. But there is a lot of support. Nurse, CNA, volunteers, chaplain, social worker, vigil support for the active dying phase, and bereavement counseling for 13 months. They also provide the necessary supplies and training on how to better care for your LO, free of charge.

As a volunteer, I visit my clients once or twice a week. I'm only allowed to do four hours of work per week, so my current client's spouse consolidates this time so she can run errands or do some self care. I read to my client, hold his hand, sing to him, sometimes just sit there and watch him sleep. I help the wife unload groceries and talk to her about how she's doing. Often, my client and client's family and me become quite close.

People misunderstand and think that hospice provides all the care, all the time. However, it's possible to check your loved one into the hospital or a residential hospice for a break…say you're going to a wedding. This is where cost comes in, depending on your insurance. Medicare won't cover the "room and board" care at a care facility or hospital. They WILL pay for the meds, doctor consults, nurses, CNAs, etc. If you have supplemental insurance, they might cover this.

I hope your loved one has a peaceful time, and this is a tender time for all involved.
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Once you are signed up for hospice it doesn’t cost anything. But they do not supply around the clock caregivers. That is up to you or another family member. There can be other costs. It’s advisable to rent a hospital bed as it makes it much easier to care for a bedridden person. You might also need a commode and a shower chair.
I found those things very helpful. Hospice will often supply bed pads and diapers but I also bought those out of pocket.
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TeethGrinder65 Mar 2023
Equipment costs are often covered.
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I thought of Hospice as the medical experts/supervisors with me and my husband the hands-on trainees. We could call them anytime with questions or ask at the twice weekly visits. They are your go-to. There is also a social worker who will initiate the difficult conversations such as DNR, funeral arrangements, last wishes, etc. Just having the knowledge of what to do in any given situation or someone to call if you don't know is invaluable.

Having the bath aide was very helpful; I felt my MIL was more comfortable with her experience and confidence than when I was showering her. I changed the bed while she was being showered. Medicare picked up the entire cost and even paid for some things that were previously out of pocket: incontinence briefs and wipes and 100% coverage of medications. They brought out oxygen equipment in case she needed it. We still had to buy toiletries and Ensure, and we also purchased briefs because she preferred a different brand than what was provided. There is also a respite care benefit (five days per year I think) that we didn't use. I believe they also would have provided equipment like a hospital bed that we also didn't use. We had purchased a walker and shower chair before she went on Hospice but that may have been included as well.
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Hospice care itself from a legal hospice organization is covered by medicare. This includes equipment, medications, clergy, social workers, aids, and RN visits.
There may be other costs, however. For instance, in the case of my friend who recently died, she had no family. Hospice would not let her return home without 24/7 inhome "sitters" to be with her. This cost her 20.00 an hour 24/7 until her death. These folks were privately hired by my friend.
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Hospice - will help you with all your needs. They will walk you through everything. I don't know where you are at but I dealt with two different companies. One through Kaiser - helpful however the last 72 hours I had to deal with the last stages of life. The other one was Clairs here in Los Angeles and they were with me physically for the last 72 hours I didn't not have to administer the meds or call the mortuary. I just had to give them the information when we signed up and it was a relief at the end when I was really emotional.
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My dad was in at-home hospice care during his last 16 months (he had stomach cancer). He was 85 when he died. Medicare paid for everything - we never saw a single bill. The hospice service was not a private company, but rather provided through our local hospital. While Mom and I were the primary caregivers, the hospice nurses were on call 24 hours a day and they visited at least three times a week and sometimes more, depending on his fluctuating condition. The chaplain was wonderful as well. She visited once a week and grew close to Dad during that time. She even performed the service at his funeral. I can't say enough about how fantastic these women were. They cried with us the day he passed. They will always hold a special place in my heart.
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Most hospice is covered by insurance and Medicare
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Gillyrich: This should be covered by your health insurance.
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Contact your local Hospice and ask them.
Get everything in writing.
It is my understanding there is never a charge for Hospice.
Be clear on their philosophy and care. They offer 'comfort care.'
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My nephew has Hospice in Tennessee for his mother, my sister, and they have been very helpful for him.

He had bladder cancer and the treatment they gave him had burned his bladder and he has been the sole caregiver for his mother for several years now.

He just recently had her signed up for Hospice and he has nothing but Praise for the help they have been for him.

It was very difficult for him in his condition to lift on his mother and do the things he had to do to make her comfortable.

I am so sorry you have not had as good luck as he is having.

Try talking to management and see if you can't get something resolved.

My husband has Alzheimer's and I still have him at home. It is difficult being the only caregiver, but I attend 2 Alzheimer meetings a month and that is very helpful to me to get all the input from everyone involved.

Prayers that you have better success with getting your loved one on Hospice.

Naomi Hartness(nee)

I don't know where you live, but if you are not satisfied with the care you are getting from them, I certainly would complain to someone in the front office.
You should not have to worry about anything as long as they are assisting your loved ones.
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Very similar to cost for home health. Insurance will cover this.
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