What are the Hospice requirements?

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I see a lot of people posting about hospice helping. Are your parents considered terminal or will they help if not terminal? My mom is 73. Chronic UTIs. Has had 3 in a 2 month period. Causes her to get disoriented and confused. Severe back pain. She is in a rehab center currently for a shld replacement but due home in te next 3-4 weeks. She has had breast cancer 4x, the last a metastases to the brain. She is confined to a w/c. She was doing her own toilet transfer but not sure how that will be now with the shld repair. She required so much help and I care for her alone. That is on top of my family. I have five kids. I am dreading her returning home just due to the stress of caring for her and my family. She lives right behind me so that helps in many ways. In others it does not. She calls for every little thing and watches our every move. She will call and say, "I see you washing the table." It's creepy feeling watched all the time. It's just hard. I know she gets lonely. I am over there every day but it's not enough. Upon her return I am concerned she will be even more dependent. I honestly don't think she will be able to do her transfers. She can't afford home health care and Medicare won't help with that. Hospice would be covered under Medicare but I thought the client had to be terminal within 6 months?

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Kannie, unless her MD says she is terminal, less than 6 months, she will not be eligible for Hospice care. They will insist someone is with her 24/7, living close by is not enough. You have a family to care for, I don't see how you could be there all day and all night. She will need a Nursing Home in that case.
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My experience with Hospice
1. The expected prognosis must be 6 months, the doctor must diagnose the patient with a diagnosis that supports this. This is a requirement for Medicare to pay for Hospice.
2. If the patient "beats" the expected life, it may be extended. If the patient gets better, they may actually be removed from Hospice.
3. Hospice may be at the patients home (personal, AL or IL) or at a Hospice facility.
4. Vitas Hospice (at home) required a family member be present at home all the time. They provided 24X7 only while the patient was being stabilized or when death was imminent. They were there for monitoring and comfort care. A nurse dropped by daily, but just for a check, the doctor dropped by as needed. They were clear that they did not provide custodial care. They required a family member be home at all times.
My experience was from 2 years ago, and the 24X7 coverage never stopped because dad progressed from stabilizing to imminent very quickly. The nurses were very kind, they did provide comfort care.
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Very nice booklet! An important thing to notice is that if the patient is expected to live only 6 mos and makes it longer, they don't get kicked out! My mthr has been on hospice longer than 6 mos, which is far longer than we expected. Kannie, I think you might be able to make it work with the benefits outlined in the book!
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Hospice has changed a bit over the years. Here is a link to the current Medicare Benefits for Hospice. It is a very easy booklet to read and should help answer your questions. http://www.medicare.gov/Pubs/pdf/02154.pdf

If you have a Hospice provider in mind just give them a call and they will help guide you and can provide a free assessment to determine if she qualifies. If you are not sure who to call here is a link to help you get started with the search. hospicedirectory website
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First, hospice cares for the person in their home whether that is a house, an independent living apt, or a nursing home. They can take care of the person's hospice needs only if the person is only reaching out for comfort care and not curing the cancer. In your mom's case, she has 4th stage cancer, so she would qualify if she stops trying to cure it. However, the big issue is that she needs more than hospice can provide.

I have 4 little people at home and I home school, so I know how hard it is to try to run the household. As many viruses as I catch from the children, I know that I cannot even visit immune deficient patients when I'm exposed, much less care for them and change Depends. Having a dying grand parent so close cannot be good for the children - they receive the message that if you are old and sick, you are isolated from people. If they see grams in the nursing home, they see that if you get sick, you get taken care of and get to see people.

Although we want to have the ideal multi-generational household, there comes a time when it is no longer feasible. If you add in hospice care and oversight to a Medicare home, your mother will be very well taken care of!Her last few months could be happy ones surrounded by people instead of isolated in the outbuilding peering out at the world she's no longer part of. How sad. But - at the nursing home she can see many people go by. I think that is the better situation, and one that teaches our children the right kind of compassion.
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