How do I get hospice care for my Mom?


Mom doesn't qualify for Medicaid but is home bound and needs help. She has minor medical issues along with her major issue of CHF and bad kidneys. The worst is her venous status ulcer of the leg which I have been treating for the past few years myself because she is strictly home bound and I'm unable to get her to a wound clinic. I have read in various posts that we can get hospice care because she shows signs of failure to thrive. She no longer walks at all and it takes both my husband and myself to get her around.

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That wasn't my intent, and I'm sorry if that was the way it was perceived. I was trying to clarify the situation, which often is necessary to answer questions.

I hope you find the answers you're seeking and wish you success in that endeavor.
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My Mom received testing in December for her CHF at the hospital. She underwent an ultrasound of her curated arteries, a cat scan, and a test for her ejection fraction. She was seen by a wound care specialist a neurologist, a nutritionist and a kidney doctor. I also do home testing for her protombine levels weekly. I work very closely with both her cardiologist and her general practitioner as well as consulting regularly on her wound care. Her wound care was checked and reevaluated during her December hospital stay so YES I am taking care of my Mom even though I am not a nurse. I have been caring for her at varying degrees for the past 20 years. She's made it to 92 so I must be doing something right. No, I have not been advised that my Mother should receive hospice care and the term "failure to thrive" came from an article I read. I've been told many different things by many different agencies about what care I can get in home for my Mom. Everyone tells me that without Medicaid she is not entitled to anything. I just wondered if anyone has been able to get hospice in without a person being diagnosed as terminal. So...I'm sorry if I've made you "uncomfortable" with my question which I notice that you didn't even comment on the topic at hand but found fault with my handling of my Mothers care.
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Some of your statements raise some questions that make me a bit uncomfortable about the situation (not in a critical, but rather an inquiring way):

1. CHF, bad kidneys and the ulcer...are you an RN who feels comfortable treating these conditions at home, without the benefit of x-rays (such as for the CHF)?

2. If so, I'll feel more comfortable about your mother's home treatment, but has she not seen any doctors in the "few years" since she's "strictly homebound"? Or are you able to get doctors to make home visits? If not, how are you able to determine whether any of the conditions are getting worse or better? I ask because I have the impression that your mother hasn't had anything but home medical treatment in a few years.

3. Have you been advised that your mother's condition is appropriate for hospice?

4. Who diagnosed the "failure to thrive" condition?

5. Depending on where you live, you could find a number of medical transport services that make door to door stops. Some may have the equipment and training to help your mother out of the house and to medical treatment.

6. If she no longer walks but you and your husband are able to "get her around", I'm wondering if you have a ramp at your home that could be used once you transfer her to a wheelchair. That would allow you to take her from the house to a medical transport van.

Granted, these aren't cheap. But check with your local area mass transit company, if there is one. In my area, there's a small bus service that will make door to door stops within a 10 mile radius of one's home. The charge is only $1.00. Yes, that's only one dollar. That's a bargain!

It's not my intention to criticize your efforts or intentions - far from it. I'm just trying to mentally sort out the several factors involved.
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As a general rule, her doctor would have to diagnose her as having a life expectancy of 6 months or less to get hospice care. I am a hospice volunteer and I have seen how beneficial the program can be for patients and their families. I recommend using a nonprofit hospice and it would be covered by Medicare.
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Fist off, you need to educate yourself about the difference between Medicare and Medicaid. Medicare is an entitlement that your mom gets because she's 65 and worked. Medicaid is way more complicated and she might qualify if you understand the rules and perhaps see an eldercare attorney. Hospice is covered by Medicare, so look into Hospice providers in your area and find one that can come and evaluate her.

Next, have you looked into medical transport for getting her to wound care ? Is she in a wheelchair? Have them transport her to any dr. Apppointment.
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