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The hospice doctor or the PCP needs to verify that the person is medically eligible for hospice.

The person or someone acting on behalf of the person decides whether to use hospice at all, and when to start (assuming a doctor has verified eligibility.)

A doctor can't insist that someone go on hospice care. But a doctor is involved in the decision regarding when someone is eligible.
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Reply to jeannegibbs
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You make the request for an evaluation
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Reply to MACinCT
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Burningout, you can ask the doctor about Hospice, but it is up to the doctor to say when the time is ready to go that route.

If you need to learn more about Hospice, here is an excellent article: https://www.agingcare.com/local/hospice
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Reply to freqflyer
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In my case it was me that decided to contact Hospice.
I stopped into their office and asked how to find out if my Husband would qualify.
After talking to me for a bit, I answered a lot of questions I was told..."I am surprised you did not come sooner".. I was told a CNA would contact me and set up an appointment, a nurse would contact me and schedule a visit. Within that week I had a CNA visit, a Nurse scheduled for early the following week. (I am sure the visits would have been scheduled sooner but my stop into the Hospice office was on a Thursday late in the afternoon)
The next week the visits began, CNA 2 times a week, the Nurse weekly and as my Husband declined the CNA was increased to 3 times a week.
Supplies began arriving weekly, medications then as needed things like tab briefs or pull ups, gloves, ointments and any equipment that I needed as we went along.
I did not have to make any calls, I did not have to arrange delivery. The nurse would call and schedule for a day that was good for me then I was called by the equipment company and informed when the items would arrive.
My choice to start Hospice for my Husband was undoubtedly one of the best decisions I made in the 12 year journey.
By the way he was on Hospice for just over 3 years, so for anyone thinking there has to be 6 months or less...that is NOT the case. As long as there is a continued documented decline a patient can remain on hospice. (As long as they are no longer getting treatments for the condition that qualified them for Hospice)
All it costs is a phone call to determine if there is qualification.

There are two types of Hospice...For Profit and Not for Profit. The Hospice I chose is a Not for Profit hospice. I can not say enough good about it (as a matter of fact I volunteer with them 3 days a week) I do not know if their Non profit status had anything to do with the care of not... Point being check several Hospice out and see what feels right. Just like selecting anything sometimes it works out sometimes not.
If you are not pleased with one Hospice you can ALWAYS call another and there should not be a problems changing or if you feel it is the wrong decision at this time you can always discontinue hospice, return to the previous doctor and later go back on hospice if you choose to. And Hospice usually has an option of Palliative Care that you could choose prior to Hospice.
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Reply to Grandma1954
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Have you considered palliative care instead? simply request it from your doctor.
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Reply to cetude
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I called the doctor's office when Mom lost so much weight, the nurse told me that I could call hospice and gave me the number. Mom was evaluated within a day by hospice, in another 3 days she was confirmed and has been on it since March. Hospice works very quickly.
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Reply to momdoesntknowme
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MACinCT is correct.

I never asked the physician for a determination for dad or dh - I made the decision and called Hospice for an evaluation. They come in and interview the person and ask medical history/questions and if the person meets the criteria, Hospice is granted.
I'm sure it is run by the physician as well, but I made the determination myself and called for the evaluation.
Dad had decided to quit dialysis. I called Hospice and they interviewed him in 2011. 5 days later he passed peacefully.
DH had become feeble and frail and I just couldn't rationalize pushing him further at almost 97 years old. I kept him ambulatory until the last 3 days when he did become bedridden, this is also the day Hospice came. I actually had difficulty getting him into Hospice as he didn't quite meet the criteria. He passed peacefully after only 3 days - Hospice only supplied morphine as it can be painful when the organs are shutting down.
For both of them, I stopped all medications from the day they were admitted to Hospice. I had no desire to prolong it for either of them.
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Reply to RayLinStephens
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The doctor made the request for my dad, then changed his mind......I made the request for my mom. The main thing is that the hospice intake nurse determine that your loved one qualifies for hospice. And know that someone can be in a nursing home and receive hospice.
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Reply to lynina2
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Loved your answers ... especially grandma.

These are always such hard decisions to make.
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Reply to Betsysue2002
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For those who called Hospice without discussing it with a doctor, a doctor did have to sign off eventually. Whether for profit or nonprofit, they still have to stay within the guidlines. There always has to be a doctors order in place. A nonprofit still bills Medicare. Medicare and donations are how a nonprofit pays for their overhead. I doubt if the nurses work for free.
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Reply to JoAnn29
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