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2 1/2 years in HOSPICE she’s not getting better and I have to have help and don’t know what to do after the doctor suggested that there was fraudulent activity. I can barely roll my mom over to change her anymore.
Sounds like it's time to have your mother placed in a skilled nursing facility where she will receive the 24/7 help that she now requires. And if money is an issue then you'll have to apply for Medicaid for her.
I promised dad she would die in her home - if I did what you said now we would have been out of money for care - who knew she was not going to die in 6 months
Jez wow -? Seems discarding parents is a thing on this channel
According to your other post, Hospice evaluation did not access your mother to be within 6 months of end of life and with no decline in health Hospice was withdrawn.
Your what to now is that you either place her in a Long Term Care Facility with her going on Mediciad LTC or you will need to pay for services to help care for her at home. You can apply for community need Mediciad if you wish to keep her at home and age in place.
Contact social services in your county, if in US, and ask for assistance. And, you can consult with an eldercare attorney with knowledge in Mediciad Long Term Care to help you navigate the process that will need to be done for services. Are you POA, Health Care Proxy and have authorization on her bank accounts to conduct the financial aspect of her bills.
There is much more information needed to guide you to the correct departments and avenue to help your mother. Every person has an unique set of circumstances that prevent this forum from giving you step by step directions. Every state has their set of regulation that is why you need your county social services assistance.
Your note is confusing. She say she has been "in Hospice for 2 1/2 years". There are few in-facility Hospice organizations now, but apparently you found one? Hospice is, in fact, end of life care. It means that you have fewer than 6 months to live in the opinion and evaluation of your doctors. If you do NOT die within that time it can occasionally be renewed, but it's unlikely to removed over and over again when you are clearly NOT in a dying stage of any kind.
Apparently you have accepted your mother home and now cannot manage care. It is time now to call APS and discuss all this with them, telling them you cannot physically in any way manage care in home. Your mother will be placed in care according to her assets. If there are no assets then application for Medicaid will have to be filed.
As to the "fraudulent" part of this, we have no details from you, so couldn't comment. Good luck.
I can manage care with help - I have a home already- I don’t need my mother’s home? You sound like the new hospice accused me of fraudulent care?? Are you a health care assistant or just talking to talk? I’m looking for help to get my mom to heaven in her own time? Maybe read above on more details - seems we are being punished because she outliv d the business side of death
I am POA - Health Director- etc - I promised dad to have her die at home - we live in Aguanga ca and it’s in a remote area - I never had this happen in my life so I’m reaching out to ask why is she being taken off hospice ? She is bed bound and can barely be rolled over - she is on Fentanyl lexipro galbipetin Xanax hydrpmorphine - she has dementia and PHN a nerve disease- I just need diaper supplies and drugs delivered really - the audacity of the hospice to say this may be a fraudulent situation because of her lasting so long is crazy - we don’t seem to come with an expiration date - what should I do now - they just took some of my IHSS pay away also cuz of a SOC on aid and attendance from dads VA pension- I’m a big overwhelmed - I’m need to find a device to deliver at the very least- I cannot leave her bedside thx Karen •••
If the criteria for hospice was the person going to eventually die, we would all be in hospice. I believe that you need a medicaid eligible care facility. This is the option for the kind of help that you need if someone needs to be by her bed 24/7. The doctor is probably just telling you the rules that apply for everyone.
This is not an unusual problem, but if someone who is expected to die within 6 months does not seem to be moving towards death, hospice may be removed. You're correct that the 6-month time span is often an inaccurate estimate, so I don't understand why fraud is being suggested.
At the beginning of your post, you report that your mother has been in hospice for 2-1/2 years and isn't getting better, but you are also upset by the removal of hospice because your mother has not died after 2-1/2 years. Hospice is not intended to get you "better" before you die, but to make dying a more comfortable process than it would be without hospice.
Look into the area around you for personal care aid assistance. Normally if your parent is on state aid or as a long term care insurance this service can be covered. This would then give you the access to someone coming each day to assist with her. It is a non skilled home care service you are looking for. You can pay privately but depending on the area you live in it can run from 30 to 45 an hour.
Art girl, hospice only provides bath aides twice a week but changing occurs multiple times a day. Why is that harder now than it was? Is it because mom has run out of pain meds?
Dementia can last for years. Hospice did not come in for my Mom until she was actively dying. To receive Hospice for Dementia a doctor has to say the patient only has 6 months to live. PHN is considered chronic but not life threatening. From what I read, it can become debilitating though. Just being bed bound does not mean Hospice is needed.
The fraud may be because the Hospice has been falsifying Moms reports to Medicare so they can continue getting paid. Medicare determines if Mom stays on Hospice and they must feel she is not dying in 6 months.
You being paid by Medicaid and Mom getting Aid and Attendance...both are government programs and I don't think Mom can have both. You can get paid from the A&A or pay an aide. For you to get paid by Medicaid, Mom probably has to drop the A&A.
When you told Dad you would keep Mom in her home, he had no idea what that entailed. Your Mom needs professional care. You should talk to Moms Medicaid caseworker and see if Mom can be taken from in home care to LTC. You will still need to drop A&A but should get $90 for her Personal Needs Acct.
You could also ask caseworker about you continuing to be her paid caregiver under Medicaid if you drop A&A, if you want to keep her home.
Medicare fraud is a real thing and not your fault, but your Mom seems she may be the unfortunate victim (and you).
Also, sometimes people do "graduate" from hospice. My MIL was in a LTC facility (here in MN) when the first deadly round of covid hit and she got it. She was so sick that the facility DON recommended hospice. She was on hospice for 4 weeks, but then recovered and went on to live 4 more good-qualify years.
Please understand that making a promise to your Dad about dying at home may have been a generational thing, when "old school" nursing homes were all mostly truly awful. They have improved over the years and better ones do definitely exist. Also, I don't think your Dad could have ever imaged the personal, emotional, physical and maybe even financial cost to you of keeping this promise.
I realize we are in the middle of a govt shutdown, but if social services for your county is still open, please call and have a social worker come out for an assessment for in-home services. You may even want to consider having your Mom apply for Medicaid, which may be able to provide some in-home aids (but it won't be full time).
If your Mom has any funds, maybe consider privately paying for an in-home aid to give you a break. There will be a heavy price health-wise for you to pay if you keep on attempting to move your Mom by yourself. I'm sure your Dad didn't factor this in when considering his promise.
I encourage you to be open-minded to solutions. Sometimes "dying at home" is just a romanticized notion that comes at a high cost to the caregivers. If you switched roles with your Mom, would you want your daughter to wreck herself due to your care when there were other options? No solutions are perfect.
May you receive wisdom and peace in your heart as you find appropriate care for her.
So beautifully stated. I ,too, pray that @Artgirl11 can find the best solution for her mother, forgive herself, and move on with her own self-care and life. My momma, almost 83, asked me "don't ever let me go to one of "those" places." I am in the home care aide business. There are SO many lovely places for hospice and memory care/long term care now here in IL. I let her know that the only way she would ever have to go is if I physically couldn't care for her anymore. I just turned 60 and I have LTC as a part of my insurance (Primerica Term Life). In IL if you have Medicare, they completely cover Hospice care, in or out of your home. At home, they care is not 24-7, but the state still allows for a home care aid on top of hospice care. We did this at home for my Poppa, he passed away at home 3 days after hospice started.
Hi Artgirl. I just want to chime in that my LO has been on hospice in for over 2 years at this point and counting. Her decline has been a very gentle sloping one, but decline nevertheless. The first hospice comapny that we worked with discharged her after less than a year. The second one (our current one, which is thru the hospital in our area) has had her for 1.5 years, and they are wonderful. They do what the first did not do: they take note of every symptom and decline that we mention to them, in addition to the ones that they notice on their weekly visits. This is what the first hospice co. should have done, but I think they were looking for the big declines, not the small incremental ones. Is there another hospice agency that you can invite to do an assessment of your mother? I am sorry you are having to deal with this. Its challenging enough to care for someone at home, without having hospice support snatched out from under you.
Hello! I am glad for you that you found a second hospice to care for your LO. I am interested to know how this process went for you. Was it difficult to qualify for a different hospice when the first one had discharged your LO? Did you just call and ask the second hospice for an eval?
Your mother's condition does not specifically qualify her for Hospice. Hospice is not a caregiving service. Perhaps the Hospice service she has been on has falsified her records in order to keep getting paid for having her enrolled. You need to arrange care for your mother, probably in a care facility. That does not involve Hospice unless your mother is expected to die within 6 months and being bedround does not mean she is dying.
What kind of Fraudulent Activity? I don't understand the question.
I believe your first concern is and should be continuing Mom's medication. She will not do well if opioid medication is suddenly stopped. Talk with her doctor about medication options. Does he suspect opiates were being misused? Is doctor refusing to prescribe the same medication?
She doesn't need to be in hopsice to get help. Is she on Medicaid? Call the medicaid social worker and ask about paid in-home care. It sounds like this is becoming more than you can manage at home. It could be time for your mother to be admitted to a skilled nursing facility. They will manage her medication and her personal cares, and Medicaid will pay for this if she doesn't have the funds.
This is confusing to me. My loved one was denied hospice care after his Doctor recommended it because he didn't have a terminal illness. He has vascular dementia, liver disease, a serious digestive disease, a growth on his lung, and COPD. He has lost about 80 pounds too, and last year he had bladder cancer which was resolved with surgery for now. His Doctor wanted him to stop UC treatment, and 'let it all go'. Well we pushed back because he is only 64. He is now in a dementia unit being cared for. I wondered what qualified your Mother for hospice care.
Artgirl, from your replies below -- just because your promised your father to keep your mother at home, doesn't mean that is the best place for her to be, with a family member who can't manage her needs physically. That is NOT a criticism of you, it's the simple reality that additional help is needed and that being isolated in a remote area without the ability to hire trained, skilled caregivers makes the situation unsustainable. Look into facilities that are equipped to provide what she needs. I hope you will be pleasantly surprised, and relieved. It won't be abandoning her, it will be providing what is necessary for her. I know this is challenging and hope you will find the right solution. Let us know how it goes.
“I promised dad she would die in her home” is a lot like the promise “till death do us part’ (or words to that effect) in the marriage service. It doesn’t stop divorces.
Contact an attorney. I am not clear on who this MD is - with hospice? Ask for legal documents specifying MD's report. "Suggesting" doesn't sound to me like a legal ability to terminate someone from care.
I am not clear on if your mother was (or still in?) a nursing home on Hospice or on Hospice at home and no longer entitled to Hospice services.
Contact the licensing board of whoever 'discharged' your mother. Perhaps hire an attorney.
From my understanding with Hospice, they can stop services when they deem Hospice is not necessary any longer. What you need to do is find out the specifics of 'suggested' fraud (with what - your mother's needs?) and if her needs changed which Hospice no longer covers.
what does dr mean when he "suggested" there was fraudulent activity? Be more specific. Are you using the chucks and draw sheets to move your mom? hint: cross her leg over other leg in the direction you want her to go. Also, do you have a lift machine? That's a long time to be on hospice...I heard it's for 6 months or so and then has to be renewed. Hugs.
OP, I also had Mom enrolled in hospice in a remote area without many options.
Pick up the phone and call the hospice. See if they can send an RN out to check on her to get her reenrolled in hospice. In our remote area we could self refer to hospice.
It sounds like the doctor that made the comment thinks hospice was keeping her fraudulently enrolled to bill the government.
there is a difference between "not getting better" and the Medicare requirement of continued decline. If you have noticed a continued decline has it been documented and is the Hospice staff aware of the decline? The decline can be anything from weight loss, sleeping more, eating less.
You can ask for a review, they should give you this option. You can also contact another Hospice agency.
Any of the equipment that you had to SAFELY care for your mom can be ordered by her PCP. And the PCP can also order Home Health visits.
By proceeding, I agree that I understand the following disclosures:
I. How We Work in Washington.
Based on your preferences, we provide you with information about one or more of our contracted senior living providers ("Participating Communities") and provide your Senior Living Care Information to Participating Communities. The Participating Communities may contact you directly regarding their services.
APFM does not endorse or recommend any provider. It is your sole responsibility to select the appropriate care for yourself or your loved one. We work with both you and the Participating Communities in your search. We do not permit our Advisors to have an ownership interest in Participating Communities.
II. How We Are Paid.
We do not charge you any fee – we are paid by the Participating Communities. Some Participating Communities pay us a percentage of the first month's standard rate for the rent and care services you select. We invoice these fees after the senior moves in.
III. When We Tour.
APFM tours certain Participating Communities in Washington (typically more in metropolitan areas than in rural areas.) During the 12 month period prior to December 31, 2017, we toured 86.2% of Participating Communities with capacity for 20 or more residents.
IV. No Obligation or Commitment.
You have no obligation to use or to continue to use our services. Because you pay no fee to us, you will never need to ask for a refund.
V. Complaints.
Please contact our Family Feedback Line at (866) 584-7340 or ConsumerFeedback@aplaceformom.com to report any complaint. Consumers have many avenues to address a dispute with any referral service company, including the right to file a complaint with the Attorney General's office at: Consumer Protection Division, 800 5th Avenue, Ste. 2000, Seattle, 98104 or 800-551-4636.
VI. No Waiver of Your Rights.
APFM does not (and may not) require or even ask consumers seeking senior housing or care services in Washington State to sign waivers of liability for losses of personal property or injury or to sign waivers of any rights established under law.
I agree that:
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I authorize A Place For Mom ("APFM") to collect certain personal and contact detail information, as well as relevant health care information about me or from me about the senior family member or relative I am assisting ("Senior Living Care Information").
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Why was your Mom put on hospice to begin with?
What state do you live in?
What kind of fraudulent activity is the doctor meaning? By whom: the hospice provider? By you? Medicare fraud?
Jez wow -? Seems discarding parents is a thing on this channel
Your what to now is that you either place her in a Long Term Care Facility with her going on Mediciad LTC or you will need to pay for services to help care for her at home. You can apply for community need Mediciad if you wish to keep her at home and age in place.
Contact social services in your county, if in US, and ask for assistance. And, you can consult with an eldercare attorney with knowledge in Mediciad Long Term Care to help you navigate the process that will need to be done for services. Are you POA, Health Care Proxy and have authorization on her bank accounts to conduct the financial aspect of her bills.
There is much more information needed to guide you to the correct departments and avenue to help your mother. Every person has an unique set of circumstances that prevent this forum from giving you step by step directions. Every state has their set of regulation that is why you need your county social services assistance.
Apparently you have accepted your mother home and now cannot manage care.
It is time now to call APS and discuss all this with them, telling them you cannot physically in any way manage care in home.
Your mother will be placed in care according to her assets. If there are no assets then application for Medicaid will have to be filed.
As to the "fraudulent" part of this, we have no details from you, so couldn't comment.
Good luck.
thx Karen •••
At the beginning of your post, you report that your mother has been in hospice for 2-1/2 years and isn't getting better, but you are also upset by the removal of hospice because your mother has not died after 2-1/2 years. Hospice is not intended to get you "better" before you die, but to make dying a more comfortable process than it would be without hospice.
Dementia can last for years. Hospice did not come in for my Mom until she was actively dying. To receive Hospice for Dementia a doctor has to say the patient only has 6 months to live. PHN is considered chronic but not life threatening. From what I read, it can become debilitating though. Just being bed bound does not mean Hospice is needed.
The fraud may be because the Hospice has been falsifying Moms reports to Medicare so they can continue getting paid. Medicare determines if Mom stays on Hospice and they must feel she is not dying in 6 months.
You being paid by Medicaid and Mom getting Aid and Attendance...both are government programs and I don't think Mom can have both. You can get paid from the A&A or pay an aide. For you to get paid by Medicaid, Mom probably has to drop the A&A.
When you told Dad you would keep Mom in her home, he had no idea what that entailed. Your Mom needs professional care. You should talk to Moms Medicaid caseworker and see if Mom can be taken from in home care to LTC. You will still need to drop A&A but should get $90 for her Personal Needs Acct.
You could also ask caseworker about you continuing to be her paid caregiver under Medicaid if you drop A&A, if you want to keep her home.
Also, sometimes people do "graduate" from hospice. My MIL was in a LTC facility (here in MN) when the first deadly round of covid hit and she got it. She was so sick that the facility DON recommended hospice. She was on hospice for 4 weeks, but then recovered and went on to live 4 more good-qualify years.
Please understand that making a promise to your Dad about dying at home may have been a generational thing, when "old school" nursing homes were all mostly truly awful. They have improved over the years and better ones do definitely exist. Also, I don't think your Dad could have ever imaged the personal, emotional, physical and maybe even financial cost to you of keeping this promise.
I realize we are in the middle of a govt shutdown, but if social services for your county is still open, please call and have a social worker come out for an assessment for in-home services. You may even want to consider having your Mom apply for Medicaid, which may be able to provide some in-home aids (but it won't be full time).
If your Mom has any funds, maybe consider privately paying for an in-home aid to give you a break. There will be a heavy price health-wise for you to pay if you keep on attempting to move your Mom by yourself. I'm sure your Dad didn't factor this in when considering his promise.
I encourage you to be open-minded to solutions. Sometimes "dying at home" is just a romanticized notion that comes at a high cost to the caregivers. If you switched roles with your Mom, would you want your daughter to wreck herself due to your care when there were other options? No solutions are perfect.
May you receive wisdom and peace in your heart as you find appropriate care for her.
I pray for your peace and God bless you both.
I believe your first concern is and should be continuing Mom's medication. She will not do well if opioid medication is suddenly stopped.
Talk with her doctor about medication options. Does he suspect opiates were being misused? Is doctor refusing to prescribe the same medication?
She doesn't need to be in hopsice to get help. Is she on Medicaid? Call the medicaid social worker and ask about paid in-home care.
It sounds like this is becoming more than you can manage at home. It could be time for your mother to be admitted to a skilled nursing facility. They will manage her medication and her personal cares, and Medicaid will pay for this if she doesn't have the funds.
I am not clear on who this MD is - with hospice?
Ask for legal documents specifying MD's report.
"Suggesting" doesn't sound to me like a legal ability to terminate someone from care.
I am not clear on if your mother was (or still in?) a nursing home on Hospice or on Hospice at home and no longer entitled to Hospice services.
Contact the licensing board of whoever 'discharged' your mother.
Perhaps hire an attorney.
From my understanding with Hospice, they can stop services when they deem Hospice is not necessary any longer. What you need to do is find out the specifics of 'suggested' fraud (with what - your mother's needs?) and if her needs changed which Hospice no longer covers.
Gena
Pick up the phone and call the hospice. See if they can send an RN out to
check on her to get her reenrolled in hospice. In our remote area we could self refer to hospice.
It sounds like the doctor that made the comment thinks hospice was keeping her fraudulently enrolled to bill the government.
If you have noticed a continued decline has it been documented and is the Hospice staff aware of the decline?
The decline can be anything from weight loss, sleeping more, eating less.
You can ask for a review, they should give you this option.
You can also contact another Hospice agency.
Any of the equipment that you had to SAFELY care for your mom can be ordered by her PCP. And the PCP can also order Home Health visits.