Are macular degeneration injections considered "curative" or palliative for quality of life?

Pam for once I have to disagree with you. My experience in NYS is that the PCP continues to oversee the patient"s care and write prescriptions etc in, although the Hospice Medical Directer may do the same thing and in emergencies he/she is the first line of contact outside of office hours. The patient is still free to visit their own PCP if able and I have known PCPs make home visits.
I only have experience with one hospice but patients could still go to the ER if for example a feeding tube came out. Yes we did not discontinue those if the patient was not close to death and rejecting the feeds. In ten years I only saw two patients with IVs continued and that was for the purpose of pain medication.
Patients are also admitted to hospital for emergency reasons i.e. a caregiver breaks a leg, power outage or floods! and when actively dying when the family does not want others to see a difficult death, i.e. young children.
In our hospice we had arrangements with the local hospital to always find a bed and the patient was admitted under their own Dr, direct admission with no ER visit. Respite care was either hospital or local NH, no choice admitted where there was a free bed. I believe we would have allowed the injections for macular degeneration to continue but not cover the cost or transport the patient unless there was a volunteer available. We also had dentists, optometrists, PT and dietitians visit the homes. Even hairdressers as volunteers.
This is a very variable subject and different hospices have their own policies and the ability to pay for some of the services medicare /medicaid does not cover

amye123, here in NY, on Hospice, your MD's are all out of the picture. Your only MD is the Hospice MD. No more office visits or ER visits or Hospice pulls out .

Hospice patients can leave house to go to the doctor. That's a common misconception that is true for some home health care situations

It's important to know what your insurance carrier says about this. Call your Medicare Advantage provider and ask them. Now, logistically, once a patient is housebound/bedbound, I don't see how it could continue.

Yes, I misspoke. If anything will make the end of life more comfortable, then do it. Best wishes!

Its my understanding that hospice care is to make the person comfortable and pain free but not to prolong life. If the shots enable her to be more comfortable (because she will be happier being able to read and see) it makes sense the shots are allowed. They have nothing to do with prolonging her life.

If someone is entering hospice care, the doctor has determined life expectancy is from 6 months or less. There is nothing you can do to prolong life in this circumstance, except the person's will to live. Macular degeneration is progressive so with or without injections will still not prolong her life.

Laser surgery is only used for the less common wet form and very few people benefit from it. I do hope your mom can continue to get her shots. Being able to read will bring her much comfort during this time. I know my mom would love to be able to read but has not for the past 15 years. Big hugs to you both

Hi, I'm a hospice nurse/case manager. She's fine to continue the injections with hospice. Hospice only considers curative treatments for the "terminal diagnosis" a disqualifiction for hospice. Since macula degeneration isn't a terminal diagnosis for hospice, it's allowed and is covered by insurance and/or medicare the same as it was before hospice. Hospice won't pay for them though.

These injections will not prolong her life, but do contribute to her comfort. I would think that the injections will be covered.

My father had it too. He had laser surgery and he could see again. In out patient procedure.

That is a question for your hospice provider. They will not insist they are discontinued but they may not agree to pay for them. It is usual for hospice to cover the cost of medications related to the terminal diagnosis so depending on their organization's financial situation may be able to cover them.