Follow
Share

Mom doesn't qualify for Medicaid and, therefore doesn't qualify for ANY kind of home health care or any other kind of assistance whatsoever. I did, however, find out that her health insurance does offer in-home health care but ONLY if she's considered to be in hospice health care, having six or less months to live.


I asked her neurologist if he would be the doctor to make that determination (since he's diagnosed her as high-medium to low-severe Alzheimer's) but he said no.


SO... would it be her Primary Care physician and, if so, what would she base her criteria on in order for Mom to be eligible for hospice home health care? Does anyone know or should I call her insurance company? Thanks!!!

Find Care & Housing
Medicare has criteria for hospice in which the patient has to be showing a decline in factors such as losing ability to ambulate, poor appetite with documented weight loss. Dementia is a factor but not a strong. Interpretation may depend on who does the evaluate. My in-laws qualified for hospice due to pain and needing pain meds, not eating and weight loss and she broke her hip and would walk walk. She died but he stabilized so although he is much more confused and that has declined a lot, he is eating and gained a pound. So he will be discharged from hospice. Wat he received from hospice was 2 visits a week with RN. She did not really do physical care but she did change dressings and 2 visits per week from an aide to do his shower. Hospice does not provide extended or frequent visits for care even for patients who are in a private home. PCP writes order for assessment but hospice nurse evaluated to see if they qualify. And they are re-assessed every 2 weeks.
Helpful Answer (2)
Reply to dogparkmomma
Report
lotsokittycats Feb 14, 2020
Thank you SO MUCH for your helpful answer!!!
(1)
Report
This will not be 24 hour care if you get hospice. You will get a PCA, a nurse and social worker for just a few hours a day. Whether high, medium, or low, someone with Alzheimer's as the only diagnosis can last several years. My MIL has been in the severe stage for 5 years. She is bedridden and still hanging in there
Helpful Answer (1)
Reply to MACinCT
Report

In our situation, we reached out to hospice first. We then gave them written permission to contact dad’s physicians for info and the order for hospice care. We never had to speak to any of dad’s doctors again. Hospice took care of everything.
Helpful Answer (3)
Reply to Plymouth62
Report
lotsokittycats Feb 14, 2020
Very interesting. Thank you SO MUCH for your helpful answer!
(1)
Report
Contact the Hospice of your choice.
There are 2 basic types For Profit and Not for Profit.
Contact the Hospice you choose and have them come and evaluate your mom. They will most likely contact her doctor and use his or her evaluation in the process.
The 6 months or less is a "guideline" it is not hard and fast. As long as there is a continued, documented decline a person will probably remain on Hospice. (My Husband was on Hospice 3 years)
There are many advantages to Hospice.
Hospice will have a nurse come in 1 time a week, a CNA will most likely come 2 or 3 times a week. You will be able to take advantage of Social Worker, Chaplain as well as other Therapies. You will get medications delivered to your home. You will get supplies and equipment and you can ask for a Volunteer to come and sit with her to keep her company.
No need to call the insurance company. If she is Hospice eligible they will take care of all that.
Hospice becomes your "go to" no 911 calls all you have to do is call your Hospice and they will come out if it is necessary. Hospice will make the determination if a trip to the hospital is necessary. The only restriction is there can be no treatment for the condition that qualified the person for Hospice. But other conditions can and would be treated.
Helpful Answer (2)
Reply to Grandma1954
Report
lotsokittycats Feb 14, 2020
WOW!!! You've given me a LOT of amazing, and some SURPRISING information, Grandma1954!!! I feel more hopeful now, too!!!

THANK YOU SO MUCH for your VERY helpful answer!!!
(0)
Report
It would be her PCP. He can make the referral for hospice. Her dementia should qualify her. I believe she has a formal diagnosis right? Contact her PCP and try to get a hospice referral. She doesn’t have to be considered end-of-life in order to qualify since she has a terminal diagnosis. My MIL had to have her doctor refer her for hospice, they wouldn’t come out to assess her without a referral. Good luck! Also I just explained ways to spend down the $19k on your other post.
Helpful Answer (1)
Reply to worriedinCali
Report
lotsokittycats Feb 14, 2020
Thank you SO MUCH for your helpful answer and I'll be sure to read the other reply you posted regarding the 19K as well!!!
(0)
Report
Call several hospice providers in your area and seek their input. In my experience, non profit hospice priders are the best.

They may be able to send some out out to assess your mom.
Helpful Answer (2)
Reply to BarbBrooklyn
Report
lotsokittycats Feb 14, 2020
Thank you SO MUCH for your helpful answer!!!
(0)
Report

Ask a Question

Subscribe to
Our Newsletter