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My 97-year old MIL, who has congestive heart failure and dementia, has been on hospice for the past 18 months. Now, however, Medicare says she no longer qualifies for hospice services. While her condition has not significantly changed over those 18 months, we think she is weaker, has more breathing issues, and her dementia is a bit more advanced. Has anyone else experienced this or have any ideas on getting hospice care reinstated?

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Generally someone is admitted to hospice only after the doctor says that, in his medical opinion, the patient has no more than 6 months to live. Now at the end of that 6 months of course, they don't usually open the door and apply a boot to kick the person out, but they do re-evaluate. In all truth, at 18 months your senior has convinced them that she DOES INDEED have more than 6 months to live. It also matters if the patient is accepting somewhat aggressive treatment; most are on comfort care and many meds withdrawn. That would be almost impossible for the CHF senior as the lungs would fill with fluid and the breathing would be very challenged, air hunger something that is to be avoided at almost any cost.
So basically she has outlived hospice. Not once, but now three times. So it is hard for them to qualify her. She can continue in palliative care, but I doubt they will reinstate hospice. So sorry that is the case, because she has a dire diagnosis in an elderly woman. Wishing you the best.
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