Please explain Hospice and how it works in basic terms? - AgingCare.com

Please explain Hospice and how it works in basic terms?

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What about the Director of Hospice can you explain what they do and are responsible for and what their goal is? What is the percentage of funds that Hospice gets on each patient admitted to them? Where is the financial incentive on all sides. What to expect, how do they determine? How do they continue to work the claim? What can I expect coming into our home and for how long? Who is best for Hospice? Why is the Director more like a sales person to me?

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I don't have anything to add beyond thanking MrsJBerg for the great question and everyone for all their helpful answers; this as been insightful reading for me as well.
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Reply to OneLastStraw
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I'm in California and my MIL is on hospice-through the visiting nurses association. I don't know what the hospice director here does but I can tell you that all orders for supplies & medications are called in by the home health aid and the nurse that comes weekly. For medications the nurse contacts MIL's dr & gets it approved. My MIL is assigned a hospice social worker, a case worker, a nurse and there are home health aids that come 3 times a week to bathe her. The aid is with hospice, its not an extra service we had to set up. Also hospice had to be set up by her doctor, we couldn't just call and get it set up. Medicare is paying for everything including the aid. The director has not contacted anyone in the family and the staff we have dealt with are not pushy, they make suggestions and recommendations.
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Reply to worriedinCali
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Hello,
My mom 95, has been on hospice since July. We use Kindred hospice care. It has been such a blessing. She is in her own home, but a patient can also receive hospice care in a nursing home. Patients can be on hospice for a very extended length of time. They are reevaluated every 6 months, to determine if they still meet hospice criteria. They can also get well enough to go off hospice​, and go back on if they get sick again. Medicare pays for hospice and they supply all her medication, medical supplies, incontinence supplies, etc. The nurse visits each week and I can reach a nurse 24/7. Best decision we ever made, in caring for our mom.
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Reply to PittyPat
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Hello,
My mom 95, has been on hospice since July. We use Kindred hospice care. It has been such a blessing. She is in her own home, but a patient can also receive hospice care in a nursing home. Patients can be on hospice for a very extended length of time. They are reevaluated every 6 months, to determine if they still meet hospice criteria. They can also get well enough to go off hospice​, and go back on if they get sick again. Medicare pays for hospice and they supply all her medication, medical supplies, incontinence supplies, etc. The nurse visits each week and I can reach a nurse 24/7. Best decision we ever made, in caring for our mom.
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Reply to PittyPat
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(((((MrsBerg)))))). Just below here there is a blue box, Find Care and Housing. There is a Hospice box. You can search hospice organizations by zip code. You can the research the various organizations before calling.

I like your idea of saying that you're a worker doing research.

For the pushy hospice company? I would tell them that my loved one is deceased. 
(!!!)

Hospice CAN be  real blessing when your loved one needs it.  But they should back off when you tell them to.

We called Hospice when my mom was already pretty fragile and a fall at her nursing home seemed to accelerating her decline. She was in pain and agitated. The regular pain meds the NH was giving, even when her doc doubled them, weren't helping.  Mom had been deemed "hospice eligible" 2 years earlier, and at hat time, we had met with the Hospice organization that worked most often with the NH.  When we called that afternoon to say we needed to se them, the RN was there within 45 minutes of our call.

She explained very thoroughly was hospice could provide and did not tell us "don't worry" or " we take care of everything". She answered all our questions.  You should expect nothing less.
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Reply to BarbBrooklyn
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Oh, I am SO GRATEFUL for all of these answers and support. I do not know about Hospice and I am being told so many things.
Barb Brooklyn, Answers beneath
Mrs. Berg, I see on your profile that you are thinking that someone who says they are the director of a hospice company might be a scammer. That could be! It feels more like a sale and a convincing than the concern for care.

Did you contact a hospice organization on behalf of a relative?
Yes for my father

Did your loved one's doctor tell you that they were going to refer you to a Hospice provider?
No, they recommended Hospice and said I should do my research, they said they don't refer for there is a liability issue, that made me nervous going in.

Please come back and let us know!

Dear Freqflyer, Thank you that is comforting to know. No, the Director is more like a salesperson to me. I am just very confused about these people are persistent. I called a few to question and they are all calling my phone, I had to turn it off for I became overwhelmed. I am not sure about California which is where I am from. The doctor said that they would have a nurse come out but I thought the caregiver came from the Hospice too, so I am confused, it sounds like that is additional and I'm guessing there is a charge for that from Hospice or someone else? But your information is hopeful so thank you.
Garden Artist, YES it is convoluted, I have looked and there are DBA's and LLC's and it is confusing but I like what you did going to the LLC directly. The Director is very pushy and car sales like, telling me things like they will handle it and are a bit aggressive, saying that they know what they are doing, I just don't trust them at this point. I have someone else I will call back they sound more understanding, but there must be big money involved for they are all calling me. If Medicare pays than I am curious what the cut is for them and their doctors? It must be lucrative. I also called some places earlier and said I was a hospital volunteer and we were gathering information, that was interesting like you said, some of the people are new to their company and that would be fine, but I do not think they can vouch for anyone new either. I wish the doctor would get more involved, but his nurse told me to call the hospital staff and ask the nurse who discharged my dad a few months ago. I am going to try that tomorrow, it's all very exhausting. Yes, I am considering now treatment in a nursing home for I cannot manage my dad all on my own. My brother came in to help but he only wants to help if he can take over the will and be POA. I know my dad set it up for me to take care of him but I wish I knew more about this going in, it is a lot to take in.
Thank you, everyone! We are grateful.
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Reply to MRSJBERG
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This is an interesting topic, one I considered when I was trying to find competent private duty care and subsequently for palliative and the hospice care.

I checked the Michigan corporate records database on private duty companies, learned their corporate configuration, and to the extent possible, who was involved with the company.

Something interesting was that many were assumed names (d/b/a/s), franchises which operated under an established national name, but were owned by individuals. More interesting was that some of them were owned by LLCs.

I did this for the one I hired, and plan to go directly to the LLC members if I have to to make sure the deposit balance is returned.

I think the smooth operation, caliber of staff and ownership depend on who purchases and operates the franchise. While FF and 2 friends of mine had a good experience with the private duty firm I hired, I did not. Had I hired the same national company's franchise in a different area, the experience might have been better. But jurisdiction Is carved up like a Thanksgiving turkey. I had no choice of going to that national company's franchise in a different area.

I also learned that some good private duty firms had nurses do the initial assessment. One firm planned to send out an "account executive". No way would I give personal information about my loved one's health to an acct. exec!

I get the impression the person with whom you've been meeting is more of the "account exec" category. Do you know anything about this person's background?

Once I was told in a phone interview with a company that one was a nurse, and that both of them appeared on the company's website. One claimed to have 20 years nursing experience. They lied. No one on the website could have been older than early 30s. There was no indication that anyone with 20 years nursing experience was on the staff.

I don't know what their scam was, but scam it was.

If you have the questions you've asked, I think you would be more comfortable digging as deep as you can not just through the questions you've asked (which are good ones), but also into this company's corporate background.

Alternatively, try a nonprofit hospice company. That's the route I took, and felt it was the best solution under the circumstances. Interestingly, there was an obviously different focus between the business side and the caregiving side. But it still was a good experience, with good staff and outcomes.

You've asked some very good questions, which I can't answer as I just don't have that kind of information. But I would suggest you follow your instincts, and come right out and ask the company, including the person who's acting as a salesperson. If they stall or are hesitant to be forthcoming, I think you can really consider if this is the company for you.

Another company which was recommended highly and seemed good, initially, was not when I pursued more and more issues, spoke to different people, and realized that the "point" person drew the people in, then someone else closed the deal. There were definitely lies being told.

You also should know that the hospice companies I contacted made it very clear they expected the family to provide 24/7 support and that they provided limited care, as reimbursed by Medicare. The scenario in which they're with you constantly only occurs if you're in a facility. That was a real "turnoff" for me.
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Reply to GardenArtist
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Mrs. Berg, Frequent Flyer has given you a good overview of Hospice. Where I live, the patient's doctor makes a referral to hospice, or a loved one can contact Hospice directly, I believe.

A patient needs to be certified as eligible for Hospice services by a medical professional.
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Reply to BarbBrooklyn
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MRSJBERG, Hospice is paid for via Medicare. It is up to the Hospice doctor to decide if a patient is ready for this comfort care. I believe the majority of Hospice groups are non-profit. This could vary from area to area. I am just relaying what was done for both of my parents.  All the equipment needs came through Hospice, I didn't need to pay for anything.

Hospice isn't an around the clock care service. Either the patient is in a facility or being care for at home with help of family or paid caregivers.

Nurse will visit with the Hospice patient to take vital signs, to see how the patient is doing, to talk to the family about any concerns.

A bath Aide will help with bathing the patient, if available with the Hospice group. And there are volunteers who will stop in to chat, be a friend, find things in common. Thus give the family a half hour or hour of "me time".

I would think the Director of Hospice would be doing the scheduling, ordering supplies such as a hospital bed if needed, oxygen supplies, and other management type concerns.

I never noticed a sale's person approach with the Hospice Rep who came to talk to me about my parents. I knew that Hospice was there to give comfort care to my parents.  Mom was in long-term-care, and my Dad was in Assisted Living/Memory Care but was at the hospital at the time it was recommended he go onto Hospice.  I was very impressed with the professionals from Hospice. There was even a 24 hour care line I could call for any reason.  And also grief counseling if I needed it.
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Reply to freqflyer
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Mrs. Berg, I see on your profile that you are thinking that someone who says they are the director of a hospice company might be a scammer. That could be!

Did you contact a hospice organization on behalf of a relative?

Did your loved one's doctor tell you that they were going to refer you to a Hospice provider?

Please come back and let us know!
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Reply to BarbBrooklyn
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