How can I get hospice involved?

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My mother has been on a sharp decline especially the past year. She gave up and long time ago saying she doesn't want to live. She barely eats and rarely drinks except to swallow her pills. She struggles to swallow them now. She has lost over 30 punds the last 6 months. I have to pick her up out of the chair bed or toilet and she shuffles to the bathroom after I put her at her walker. I can't get any help. Not a social worker not hospice. Her doctor ordered home health. They wanted to put her in rehab but she is so crippled she can't do rehab. The nurse said she would be a good candidate for hospice but her doctor refuses to order it. I am watching her suffer. She is so uncomforable and I can't even get a social worker to call me. They said it has to be a dire situation. How much worse do they want her to be. The nurse said she has a failure to thrive. I am at my wits end. My back is out and I can barely walk. I love my mother but I need help. I believe that she is dying and I would like to see her comforted. She is in so much pain physically and emotionally. I am considering taking her to another county to the er and see if I can get her into hospice there. What should I do?

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Call a hospice company yourself. They can do an assessment and if her doctor will not order the care, they can use their own doctor.
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Work "the system" then. Get online and research the non-profits in your area that provide services to the elderly. In my experience, the people at those places are the nicest, most knowledgeable you could ever meet, and they will help you. They will know about state agencies, care agencies, doctors, hospitals, etc., that could help you obtain hospice for your mom. In addition to tapping into the non-profit places, there are "elder experts" out there that specialize in assessing geriatric people. These people usually have multiple degrees listed after their name - different advanced social and medical degrees - that qualify them to make the assessment. A search online using keywords: Your City, elder, care, caretaker, expert, referral may net you the relevant contact information. For a fee they can come to your home, observe your mom, interview her, interview you, and write up their "expert" assessment which you can use to take to local hospice care providers to show she needs hospice... skipping her doctor altogether. Although your mom WILL have to be evaluated by physician and deemed in need of hospice, once you have an "expert" in your corner, it should be much easier to get a different doctor -have the hospice providers give you recommendation - to agree.
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Thank You. My mom is 78 years old. I really believe he isn't getting it. Her labs and vitals are still pretty good so I think he is going by that. Something is very wrong though. She is so weak and shaky that she can barely stand over a few moments and never without assistance. I have told him everything I know to tell him. He keeps saying hospice is for the very end and she's not there yet. If something doesn't change I don't see her making it over a few more months. Every day she is worse than the day before.
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How old is your mother? I'm surprised - shocked, really - that social workers won't get involved and doctors refuse to allow hospice care. The only thing I can think of is that maybe they somehow believe your mom is "too young" for this... which is silly, because it has nothing to do with age. Have you tried writing a very detailed document, listing all her problems and especially focusing on recent weight loss and difficulty swallowing and taking with you to her doctor? I have to believe he just isn't "getting it," and that maybe if you provide more info this would make a difference. Another suggestion for you: in every city/town there are non-profit organizations to help elderly. They are often associated with variety of religions (usually name will start with Catholic, Lutheran, Holy, etc.). You may want to tap into that resource. The staff at those places know "the system" and can steer you towards how to get hospice care for your mom.
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