When does hospice come in?

Hi, I'm a hospice volunteer. Anyone can request a hospice consult. You don't need to have a "terminal illness" if your life prognosis is 6 months or less (as it seems to be for your mom). It can last as long as needed, as others have said, as long as Mom isn't seeking a "cure." Since there's no cure for death, she would qualify.

I hope she has a peaceful ending. Sounds like she has started to transition already. Not eating and lots of sleeping are the ways we start ending life as we knew it. Don't try to get her to eat…it may well make her feel worse. Take good care of yourself, too…Hospice is for you as well.

Call the Hospice of your choice, as a matter of fact call a couple.
Ask that mom be evaluated.
there are GREAT advantages of Hospice and many people get on Hospice at End of Life and they and family do not get to take full advantage of the support that it can offer.
If the thought of "6 months or fewer" cause you concern do not worry about that. As long as there is a "documented, continued decline" a person can remain on Hospice. My Husband was on Hospice for almost 3 years.

They way you know whether she needs hospice is by asking for a Hospice evaluation.

Call her doctor and discuss Hospice and palliative care.

My dad (93) is on Palliative (a part of comfort care) care and is covered by Medicare. He receives OT,PT, nursing visits and a speech therapist who helps him with swallowing issues. An aide comes out twice weekly for bathing. He is a half step away from Hospice as he is refusing any life saving treatments (he has AFIB and heart failure) other than his medications. Quest comes to his home for lab draws (Dr. has to sign off on this through a formal request). He is ambulatory with the help of a walker. There are services out there to help families with aging loved ones stay in place.....for us it took a trip to the ER when dad was literally on his deathbed, and somehow managed to rally through with little residual effects. That said, his situation is precarious at best, but the services provided offer him comfort and a decent quality of life. Good luck....being an advocate for those we care for is a tough job.

Has she been diagnosed with a terminal illness? A doctor has to determine if the patient has 6 months or less to live before they will sign off on hospice. I had a struggle with my dad’s doctor trying to get him on hospice. He kept ordering PT and OT for him to see if it would help. When I could no longer get him in and out of bed (he had vascular dementia) a doctor on call told me to call 911 so he could be admitted to the hospital. Finally, the doctor at the hospital was able to see my dad’s true condition and he signed him into hospice. He only lived 2 weeks past that time. It would have been enormously helpful to have had him in hospice care sooner. Sometimes I think you may have to push their doctors a bit to make them realize it’s time for hospice.

Your mother needs to have a terminal illness and be thought to have 6 months or less to live in order to qualify for hospice care. But, in order for Medicare to pay for hospice, there has to be a 'valid' reason FOR hospice, such as 'terminal cancer' or another disease that is thought to take her life within a 6 month period of time. With my mother, she had dementia, but since it was not Alzheimer's, which is terminal, the nurse had to get creative to come up with the right coding to get her approved for hospice. She came up with 'advanced senile degeneration of the brain' which is a category/code that is used by Medicare. All this to say that your mother will need to fit into a Medicare category in order to be approved for hospice. Being 95 and weak with a bad appetite & mobility issues is not enough of a reason for Medicare to approve her for hospice, so the nurse will need to come up with another, better reason to qualify her.

Sample is partially right, in that insurance companies determine our care, but not from a '6 months before death' perspective. But from a 'terminal illness' perspective when hospice care is desired. And insurance determines ALL of our care in general, let's face it! If they don't determine we're eligible FOR care in the first place, we don't get it. That's life in the 21st century, and was life in the 20th century too, whether we agree with it or not. Unless we have the money to self-pay the astronomical costs of medical care and can afford to bypass health insurance companies entirely, we are slaves TO them.

Wishing you the best of luck advocating for your mom to get her the hospice care it sounds like she would benefit from.

Contact Hospice. Doctors do not bring this up when they see decline in their patients a lot of times as they are trained to "cure" them. I am giving you a response from my point of view only as a former Hospice Aide. I loved working with hospice as I was able to give the patient the extra TLC that they needed. I also was there to hear about their life and to hear their fears that they would not ever tell family.

Hospice can come and do an assessment. Contact her doctor for a hospice assessment.

If your mother is " alert and oriented" ( cognitively able to have a correct conversation and to make her wishes known) speak with her about the possibility of having hospice come in and assess her and speak with you both about their services . Her doctor also needs to be contacted and let him know, if you both agree, that you would like for him to write an order for hospice evaluation. You can even tell him/her ( doctor) which hospice you want if you have a preference. You can also have more that one hospice come out to hear from each and then make a decision. Hospice will send an RN out to do the evaluation for " hospice appropriateness" and will speak with her physician also. Then it is your and/or your mother's decision whether to accept hospice services. Also you can start, stop or change hospice services at any time as you wish. Hospice is a choice, not mandatory. Hospice is about living and quality of life, not death . Hospice can be very very helpful for the patient and the entire family , especially the PCG , primary caregiver, you ! You as the PCG and your mother the patient are in charge of decision making and a part of the " care team".
Most people ultimately say that they " wish they had started hospice care sooner that they did". Prayers and peace.

I too thought hospice was only for End of Life, but it's not! My dad just got put under hospice care because he's fell couple times and my poor 93 4'11" mom can't pick him up. Plus he began undressing himself in the living room. He does have dementia, but has NOT been diagnosed with a certain time to die. So, please know this is another avenue of care for your parent or loved one.