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My husband is in stage 6 of the Alzheimers scale. My daughter talked to a geriatric counselor who said we should have him evaluated to see if he qualifies for hospice although he does say more than 10 words but they are generally cuss words. I always thought it was free but I understand each state has their own guidelines. But generally is it free or is there a charge and where do I go to find out this information? My daughter does go to this geriatric counselor but she has already been there 3 times and I don't know when she will be going again. There should be somewhere on line where I can find out the qualifying parameters and what they charge or if they charge. Thanks.

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Is he (and you) on Medicaid/Medicare? (Please do not answer.) If you have "spent down" your life's savings, your social services workers should have all the information.
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Hospice hospice is not an actual place you go like people think. They will put you in a hospice facility if you're within 2 or 3 days of dying but otherwise if they think you have a lifespan of 6 months or less they can put you in hospice but you stay in your home and just have doctors and everything come to the house. You can live longer than 6 months but they use that six months is a guideline. Basically when you go into hospice you give up Medicare and Medicare gives the Hospice place a certain amount of money each day to take care of your needs so the hospice facility will come out and order any durable medical equipment that you made me like a hospital bed or they'll have a nurse come out a certain amount of times a week and arrange for different things like that. But it's basically that you're not going to take any Extraordinary Measures because he's no longer covered under Medicare and that's basically what you're trying to do say all right we're not trying anymore if something happens it happens
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worriedinCali May 2019
This is incorrect. You do not lose Medicare when you enter hospice care! You stay on Medicare, you don’t lose your coverage. You aren’t taking any extraordinary measures because you have accepted that you have a life limiting illness and you won’t be cured. It is NOT because you are no longer covered by Medicare. You don’t lose Medicare when you enter hospice. My gosh. If you did, then Medicare wouldn’t pay for your hospice care! Don’t you think?
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You came to the right place here for support. Keep this thread going, ask right here if you have any more questions. Or just need to vent.
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SondraO,
Congratulations on the 56 years married.
Quite an achievement and an enduring love you have.
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I now have my husband in Hospice. They approved him Friday and so far it has been very good. It will not cost us anything. Everyone I have met has been so nice. They are bringing out a hospital bed tomorrow. I don't know about a 24 hr rule about not leaving him but I don't anyway. He got out of the house Sunday morning about 6 when I was still sleeping and went to the mailbox in his tshirt and diaper.
Then came back in and hollered to me that he was going for a walk. I caught him about the time he started down the street. I have not left him alone in 15 yrs. My daughter and grandchildren sit with him sometimes. It is hard but I want him to die here at home with me. It may reach the point I can't do it. I am 74 with health problems myself but I will try. June 1st will be 56 yrs married. 2 yrs dating. We met in high school.
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Isthisrealyreal May 2019
God bless you for your devotion.

I highly recommend using everything hospice has to offer. They help so much.

Hugs!
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Medicare pays for hospice with a doctor's referral. My 97 yr old mother with congestive heart failure lives in an ALF and the hospice nurse/doctor control her meds, a social worker looks to all her needs, and she even has a volunteer go to the facility and play games with her for 2 hrs once a week. So far I'm very happy with the arrangements. As her POA they keep me in the loop on all aspects of her care. I hope the geriatric counselor will give the okay. My mother's cardiologist contacted hospice and they contacted me, and we went from there. Good luck. I think you will be relieved to have qualified professions step in and help out.
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This is what I found for the State of Alabama:

http://www.hospiceservicesofalabama.com/faq/

Copied paragraph:
Who pays for Hospice Care?
All hospice services are covered 100% by Medicare, Medicaid and most
commercial insurance plans. Gifts from our generous donors will enable
Hospice Services of Alabama to provide care to all patients regardless of their
financial situation or insurance coverage.
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My husband has Medicare and our supplemental is Federal BCBS. I want him here if it is at all possible. We don't have much savings so I will not be able to pay a lot for care. Right now I do his care. My daughter and 15 and 17 year old grandchildren help me also. His decline has been so rapid these past 12 months.
He is still eating but his appetite has certainly declined. I saw my mother in law die from this and I know it is going to be hard. But I love him and want to take care of him as long as I can. June 1 will be our 56th anniversary. My daughter and my sister have told me I have not been accepting what is happening but I am now. At this moment he is sitting on the floor. He fell and I saw him. He is not hurt but is not ready to get up yet. It takes both of us and he has to cooperate to get him up. We will sit here while he watches tv until he is ready to get up. If we can't get him up I will call for help. I prefer for us to do it. Thanks to each one of you for your contribution. I didn't even know there was more than one Hospice.
I have lots of research to do.
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Hospice is 💯 free. They are a great service.
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My mother was on hospice and died in March
it was 💯 per cent covered
she lived in memory care in California
I understood it’s that way everywhere
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A hospice facility will charge for room and board. My husband and I were in an independent living facility when he had a massive stroke. There was no room for hospital bed there, so he was examined and deemed a candidate for a free standing hospice and recommended the Methodist Hospital facility. We had to pay room and board (even when he was not eating anything), but they were there 24/7 so until the last 3 days I didn't feel as if I had to be. He had an indwelling urinary catheter that at one point got blocked with a blood clot, so I was glad that I could call on staff. The hospice staff also gave enemas until he quit eating, as he couldn't stand or walk to bathroom and was constipated, so many services you don't realize your LO will need when immobile. Medicare even covered one year of grief counseling, which was oh so helpful. I certainly want hospice care for myself if I don't die suddenly at home.
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Is this home care or in a facility? My stepfather’s Medicare did not pay for 24 hr care at home . We paid about $1800 a week for nurses.
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Both of my parents died last winter in hospice care. My mothers hospice care was provided in her nursing home and we incurred no fees for medical care. In fact her nursing home bill was decreased because we no longer had to pay for the incontinence package as hospice provided all those supplies. She was under hospice care four months prior to her death. My dad received hospice care in a hospice home. We paid $225/day for his room and board there and his insurance paid everything else. He was there seven weeks before he died and received wonderful care. Both of my parents were covered by Medicare and supplemental private insurance. I was so grateful for the care they received and found everything got better once hospice became involved as we had a plan, sound advice, and consistent care and support for them and our family.
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Sondra, is your husband on Medicare or Medicaid? Medicare covered my mom's hospice services. They even covered briefs and medications. I wish you all the best!
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Medicare should Square it away....
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Hospice is covered by Medicare or Medicaid. If someone does not have Medicare it should be covered by their Medical Insurance. If they do not have insurance or Medicare there are some Hospice that will take a patient that has no funds. (The Hospice I volunteer for never turns anyone away, they are Not for profit and I am sure that makes a HUGE difference)
The basics will be covered but some Hospice will also provide things like lotions, creams and other supplies so check and ask what they provide when you are checking around.
The Hospice I/we used I had a Nurse that would come once a week, a CNA that came 2 times a week, later as my Husband declined she came 3 times and often with another CNA to help. We had a Social Worker, Chaplain (if we requested it) we also could have had a variety of other services if they were needed or wanted. We were provided all the equipment we needed as well as medications that were necessary.
When you interview the various Hospice choices in your area ask what they provide.
You can call as many Hospice groups you want and "interview" them just like you would interview a doctors office. And if you are not happy with the one you select you can always change. I think the first question I would ask is.."are you For Profit or a Not for Profit organization?" I think I would opt for non profit. Also ask how well they are funded. Much of the information can be found on the Hospices website. And the next thing to do would be to ask to take a tour of their facilities. You may never have to use the Inpatient unit but it would be nice to see and as per Medicare you are entitled to 1 week of Respite and your loved one would probably go to the In patient unit for respite so you want it to be nice.
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Just a heads up when using Hospice in the home. Someone has to be with the patient 24/7. The nurse only shows up every 3 days or so. The aide is only there long enough to bath and dress. If you need to go out, the aide can be there longer, but u have to request it ahead. Yes, there are some Freebies, like depends but all in all the family is still responsible for giving meds, feeding, changes, etc.
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worriedinCali May 2019
Actually that’s not exactly true. It is t mandatory that there be a 24/7 caregiver. Hospice patients CAN be left alone. People who live alone enter hospice all the time. SOME hospice providers will turn you down if you live alone & don’t have a 24/7 caregiver. But only like 12% in this country.
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You can ask his primary care provider or specialist, whoever is following him most closely, they should be able to refer you to Hospice care and have recommendations for which one to use if there are several in your area. That doesn't mean you have to use the one they recommend but it's a good start. Just like being set up with home health care you can and should vet the various ones available. I think the same goes for Hospice facility if that's what the patient needs and if you aren't set on them passing at home it might be wise to look for a Hospice service that does both, my uncle for instance was on home care until his needs were just too much for home care and he was then moved to their residential Hospice, just before the end, they were wonderful. It may depend on the state your in but as far as I know Medicare &Medicaid both pay for it and if you are at an inpatient facility it's paid for like a hospital or rehab hospital benefit.
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Well we did it. Quite frankly, it was a warm blanket around all of us. A nurse had already been there this morning. To see our mom. So signing papers was a legal requirement.

I knew who to use. If you don't, contact your large hospital's social svc. dept and ask which. If they give you several, which they will, ask if YOUR loved one, which would you use?


You also search the obits in your large area newspapers. Just put hospice in the search function and which used. If your loved one in a facility, ask the charge nurse too. They know.

The saddest thing was reading the intake notes of the physician medical director. FAST score of 6d.
Mortality Risk index score of 18.9.
12 is when they say less than 6 mos.
She is seeing people who are not there. Can barely grasp a question.

But hospice is more eyes on, more care, and that is a good thing.
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worriedinCali May 2019
((Big hugs segoline)) I’m so sorry! This is such an emotional process and yes, it sucks. I’m Glad your family found comfort in it.

and really excellent advice to check the obits. Now that you mentioned that, I realize I always see the same hospice provider mentioned in the obits, it’s the one my MIL used. My husband helped his dad sign up for hospice 2 weeks ago today, I need to ask who the hospice provider it.
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I am signing papers tomorrow for this. Oh god it's the right thing to do, it gets her more services but man it sucks. Medicare part A pays.

I feel like i will sign my mom's death warrant. That's not true at all. But that's how it feels. Sunday we had her evaluated. Oh yes. She is candidate. By Monday, no. She is not. Make up your effing mind!

Medical director did (of hospice) did eval today. Yep she is candidate. And she may have had a stroke.

Here's the take away. Your parent will get more care. More services.
You are not hastening death. You are making transition easier.

God. I have been in phone with corporate, admin, and nursing this evening to find out coordinating services. Some of it was not needed but, I am not leaving anything to chance.

I know this is such a hard decision. It is for me. I wish you well and peace. Take care.
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DesertGrl53 May 2019
((((Hugs, Segoline)))) I know it's hard, even when you know you are doing the absolute best thing for your Mom. Peace to all, and a peaceful journey to her.
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If you have Medicare part A, then hospice is covered by Medicare. It may not be entirely free, there could be a very small copay for prescription drugs and if respite care is needed, then you May have to pay 5% of the Medicare approved amount. If he doesn’t have Medicare but has Medicaid then Medicaid also pays for hospice. Just know that.....they won’t cover any treatments intended to cure your husband. He (you) will have to agreee to palliative care. They will also provide incontinence supplies, a home health aide bathe him & change bed linens, respite care, and counseling services for the family. It’s not necessarily “end of life care”.

Go go ahead and have him evaluated. I’m going to assume he has Medicare, so you can go here https://www.medicare.gov/coverage/hospice-care to see what Medicare/hospice covers.
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Call local hospice providers and they will help you.

Interview them to make sure that you mesh with their view point and beliefs.

I understand that if you are on Medicare they pay. I have also read here that people were happier with a non-profit hospice. We used a for profit for my sister and we were very happy with it.

I am sorry that you are loosing your husband to this awful disease.

Hugs!
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rovana May 2019
I've read that regarding hospice in a facility, the room and board charge are not covered by hospice.
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