My mom has been very tired. She is bedridden and has trouble turning in bed and has a rash on her back. Is eating a little less and is sleeping a lot. Hospice nurse came yesterday and said the rash was just yeast and she will be discharged from hospice. She has gotten worse this week but nurse just brushed it off. I think the decision was most likely made 3 weeks ago. I guess my mother is not dying fast enough. They won't test her for anything and is getting worse and is being discharged from hospice. I feel frustrated and not sure how to help my mom. Nurse is coming back in a couple of days. I doubt anything will change.

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From the National Hospice and Palliative Care Association website;

Hospice eligibility requirements;
In order to be eligible to elect hospice care under Medicare, an individual must be entitled to Part A of Medicare and certified as being terminally ill by a physician and having a prognosis of 6 months or less if the disease runs its normal course. 42 CFR 418.20 § 418.20 Eligibility requirements.

Hospice Pre-Election Evaluation and Counseling Services (CR 3585) - Medicare allows for a one-time visit by a physician who is either the medical director of or employee of a hospice agency to:
evaluate the individual’s need for pain and symptom management,
counsel the individual regarding hospice and other care options,
advise the individual regarding advanced care planning.

In order to be eligible to receive this service, a beneficiary must:
be determined to have a terminal illness (which is defined as having a prognosis of 6 months or less if the disease or illness runs its normal course;
not have made a hospice election, and
not previously received the pre-election hospice services.

Eligibility and the Local Coverage Determinations (LCDs);
The LCDs for the hospice’s geographic area are used as guidelines to help a physician determine hospice eligibility. The LCDs are not regulations and should not be used exclusively to determine or provide evidence of hospice eligibility. Certification or recertification is based upon a physician’s clinical judgment, and is not an exact science. Congress made this clear in Section 322 of the Benefits Improvement and Protection Act of 2000 (BIPA), which says that the hospice certification of terminal illness “shall be based on the physician’s or medical director’s clinical judgment regarding the normal course of the individual’s illness.”
I hope this clears up the requirements. As I understand it, as a hospice nurse, anyone with Medicare, whose doctor determines that they have less than 6 months to live, can sign on with hospice. Once on hospice, you can NOT go to the hospital for "life extending" treatment but you are allowed to go for "comfort measures" (draining fluids to receive pain, broken bones, etc.)

There are standards that keep you on hospice (or remove you from hospice). If your mother is stable (vital signs good), not showing pain or difficulty breathing or severe anxiety, does not show decline, is eating, transferring, eliminating and sleeping well.... then she would be deemed stable and not "in need" of hospice services.
Helpful Answer (1)

When people get worse, hospice doesn't stop. It is re-evaluated and continued of the patient is in EOL. Perhaps you misunderstood the nurse. Is mom receiving pain meds and antianxiety meds? Or is she just really sick? Hospice usually means they are actively dying--within 6 months or sooner. People DO com off hospice if their health improves to the point that it's not needed, but someone who is so very ill really needs the care.

Talk to her dr.
Helpful Answer (4)

If you feel your mom should continue to qualify then you need a doctor to certify that, ask either her own primary doc or perhaps one from a different hospice.
Helpful Answer (5)

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