What criteria does hospice need to come in?

Hospice will not come in and be there 24 hours a day, 7 days a week.
They will come in a few times a week, more if needed to shower, dress and take care of some needs but that is the CNA and she/he would be there probably an hour at most.
A nurse would come in 1 time a week, a Social Worker, 1 time a month.
You need someone that will be with your Mom 27/7
Hospice will come in and assess if she is a candidate for Hospice or maybe Palliative Care.
Hospice will go wherever your Mom is so at home or in an Assisted Living or Memory Care facility.
What you are paying is about standard.
You will probably need someone at night as well. That may cost more.

When you look at the cost of staying at home VS a facility take into account you will no longer pay property tax, homeowners insurance, gas, electric, garbage pick up, water or sewer bills (if you are on city water and sewer) and your food bills will go down drastically since meals are provided. And you will not be paying the caregiver unless you wish to pay someone to come in and visit or take her out in addition to outings provided by the facility.

You can check cost where she currently is and compare costs closer to you then make the decision to keep her where she is or mover her closer to you.

I know she wants to remain at home but that may not be possible if she is at risk, if the house is not adaptable to her changing needs as she declines.
Are bathrooms large enough to maneuver a wheel chair, could you get a Hoyer Lift or a Sit to Stand into the bathroom.Are there stairs going into the house? To the bedroom? Is there carpet that might have to be torn out to make it easy to move a walker or a wheelchair or to prevent trips? Are doors and halls wide enough to get a wheel chair from one room to another? Do you have grab bars where they are needed? Are toilets elevated?
All these things will cost money to change.
Unfortunately a move often comes after a catastrophic event that requires surgery and rehab.

JLM, does she have any chronic conditions? If so, she might be a candidate for palliative care, either in her home or at a facility providing that level of care. She would still be treated for medical conditions but a visiting physician could be part of the team to treat her at home, to preempt the necessity of going to urgent care or the ER.

Palliative care is a fairly new program, from what I've been told by providers, and is a step up from hospice care.

I kept my mother home til the very end. She had hospice for a year. I called her PCP who was totally in favor of hospice for her and he called a 3rd party agency to send a nurse to do a quick examination. Her report gave him the go-ahead and he then called the Hospice provider I had chosen. They sent their own intake nurse and that was that. this all happened in two days - one of which was a Saturday!

Now to the other point of your query, my mother only asked to "go home" for a short time before I realized it meant she needed to go to the bathroom. Everyone is different!

Hospice is an awesome program. It does not solve the basic requirement to have someone in the home with Mom 24/7.

Carerick, no you wouldn't be required to add "workman's comp" to your homeowner's policy as you are a relative and not being paid. The workman comp is for someone who is an "employee" working in the home.

Have you looked into Medicaid [which is different from Medicare] to help you place your wife into a continuing care facility once it becomes too difficult for you to care for her at home. Medicaid will pay for all of her care. You would need to hire an Elder Law Attorney to help you through this maze, with you being the spouse still living at home, especially if you own a house, so that you can keep your fair share of house and savings.

Oh why does getting older have to be so darn complicated :(

Dear jlm,

I know you are trying to keep your mom at home as per her wish. Have you tried talking to a social worker? Maybe she can help access more resources in the community.

Hospice is a wonderful service but as others have mentioned does not cover home care other than a very limited support at end of life. And it can be even more difficult to be approved when you only have a dementia diagnosis to work with and typically they will not come in until they are bedbound in that situation.

Thank you freqflyer. I wish I could hire an attorney. O well God will see us thru this bump in life as he has many times before.

Carerick, you don't say where you live so I can only speak to what I know about Ohio from helping my parents. There is a senior service called Passport here that provides a wide variety of services for seniors, costs determined by income. This included free legal advice pro bono via phone. They also suggested I call Chatholic Family Services who were a big help with advice and direction in filing for Medicaid. In the end there was not much help in day to day physical care, you have to private pay that until you qualify for Medicaid. I hired Visiting Angels to come in 3x a day, cost here is $23-30 an hour but they are trained, always cover the shifts, and are licensed and bonded.

AK, I wasn't aware of this and now am wondering how the "life limiting condition" differs from a "chronic condition", the basis for the Palliative Care program.

Or are they the same level of program, with different names? Palliative Care has been recommended for my father, with the suggestion of a doctor monthly and nurses biweekly. What I haven't yet determined (haven't done that much research) is how much therapy can be provided. I've found a good palliative care company which I'll probably use; it's the best I've found through interviews so far.