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My mom has stage 4 liver cancer that has metastasized, she vomits and has diarrhea daily. The doctors have given her 6 months. She is getting weaker and weaker by the day. My step-father and I are her only caregivers, and we have to work full-time. She said today that she is having numbness in her hip and feet. She is on heavy doses of hydrocodone and hydro morphine. I believe she is a fall risk. We just don't know what her insurance will pay for or if she is eligible for someone to help while we both work.

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I'm so sorry to read that about your mother. I don't know much about liver cancer. With that prognosis, I would request a hospice evaluation though, if she is open to that. They provide some help in the home, but, it sounds like you may need much more. You might explore if there is an inpatient hospice facility nearby.
The hospital social worker may also be of assistance. There may be some home healthcare, but, it sounds like she needs help around the clock. I hope you get some more responses.
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Clearly by any marker this is the time to do it. The fact is that this today constitutes not so much the marking of setting a time in which death will occur, but rather as a means to provide all KINDS of extra support. Hospice is almost always called in too late. Medicare pays for hospice almost entirely in many cases and you get beds, preventatives for bed sores, emotional support for family and so much more. I guarantee you that, if your Mom is still living at the end of 6 months, they will almost certainly provide her services for longer. Please arrange with her primary care doctors to interview hospice agencies. So sorry for all you are going through. I had to fight to get my bro out of hospital into hospice care and he lasted only less than a week more, but it was a COMFORTABLE week, after much trauma. It's my experience we call too late, not too early. Explain to your Mom that while Hospice used to mean death, today it means mostly more care and comfort. It is also untrue that such things as bladder infections and so on are not treated. They are. It is about COMFORT not cure. And bladder infections hurt. Good luck going forward.
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Ask your stepdad to call his health insurance carrier and inquire about hospice and the options for hospice that his insurance company covers. If he works for a company that offers an Employee Assistance Program, I would also encourage him to call them and inquire about services. So sorry for you and your family.
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I would begin the process of enrolling mom in hospice NOW. I would call whoever provider she sees the most of & get the order for hospice written today.
You’ll get some hands on help with hygiene from a HHA but not many hours of actual hands on care - maybe 3-5 hrs a week. Thus, if you need more hours than that you can hire a aide from an agency to assure she is being taken care of and you two can continue to work.

Insurance should cover hospice.
Unfortunately her health will only decline and quickly. I’m sorry you are going through this.
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In most cases in home hospice is not 24 hour care. Check out insurance coverage to see what is available. A hospice hospital/home may be an option.

Hospice should definitely be called and asked to assist at this point.

She is on dad's policy through work. She is also eligible for Medicare. Has she requested the coverage? Medicare has excellent hospice coverage.
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Where I live, there's a free palliative care service that's separate from hospice and you can have both. The palliative care is affiliated with the local hospital, and it's for pain management, so not everyone they work with is dying and some of their clients are going to recover. But they have a very good understanding of hospice, and pain treatment.
For hospice, the usual standard to qualify is that you are not expected to live for more than 6 more months, so your mom would qualify. once you are on hospice, your insurance becomes hospice insurance and doesn't cover any treatments or medications that are designed to cure - only treatments for pain and comfort care. So no chemo, surgery, radiation. But plenty of meds for pain and anything that brings discomfort, so possibly for things like high blood pressure, etc.
And hospice will help care for your mom through the dying process - they don't try to keep people alive as long as possible, or hasten their passing, but keep them as comfortable as possible throughout. There should also be a hospice social worker involved who can help with making decisions about the different options for care such as nursing home or in-home, the amount you are involved, even planning for what happens when she passes such as dealing with the funeral home.
I hope this helps.
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You can call at anytime there is a diagnosis that will limit a persons life.
If she is no longer doing any treatments for the cancer she would most likely qualify. And the fact that the Doctor has said she has 6 months. (this is a guide many people are on Hospice longer than 6 months)
Medicare will cover Hospice
Most Insurance will cover Hospice.
There are 2 types of Hospice NOT for Profit and a FOR Profit. In general the Not for Profit Hospice will not turn anyone away even if they have no insurance and are not on Medicare or Medicaid (they wold probably push through the application for Medicaid)
With Hospice you will have a Nurse that will come at least 1 time a week. A CNA that will come at least 2 times a week, more often if necessary. and there are typically Volunteers that will come and sit with a patient BUT they do not do any "hands on help" and typically they are there a maximum of 4 hours. (With COVID19 most Volunteer work with patients has been suspended though)
In your case even with Hospice you really should get a caregiver to come in and be with her while you are not at home. Some areas have Volunteer groups that will do this but again in most cases these have been suspended.
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I would stop the chemo and radiation, this is not helping her at this point. It's probably why she is sick every day, it also disqualifies her for hospice.

I recommend calling multiple hospice providers to find one that meets your needs as good as possible. I personally like religious based non profits, I think that you get nicer people caring for your loved one, that's been my experience.

Is it possible for step-dad to take some FMLA? It sounds like she is getting to the stage that she can not be safely left alone. I would contact all of her friends and family and set up a chain of people that can help her and SD. We did 3 and 4 hour shifts with my sister and we fed anyone around dinner. This allowed for people to actually help and not be overwhelmed. We had a calendar that everyone could see the need and volunteer for time slots that suited their schedules. She had someone there 24/7 with hospice coming in to check meds and conditions and bathing her. They aren't going to be there to just be there, they come in and do a job and go to the next patient. This is where you all need to get people in place.

I am so sorry that your family is going through this. One thing that I want to share, my sisters cancer ate her spine and one day she started having spontaneous spinal breaks occur. This could happen to your mom, so I think that it is important that she not be left alone with her advanced stage and metastasis in the spine.

May God give her comfort and peace during this difficult time, may HE touch each one of you and give you strength and wisdom for this season of life. Great big warm hug!
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At 71 Mom should have Medicare which will pay for Hospice in the home. The problem with "in home" is they are not there 24/7 and someone needs to be there 24/7. An aide will be provided for bathing. Mom was told if she requested it ahead of time, the aide could be there longer for her to run errands. Like said, SDad may have to take family leave to care for her. Or hire someone to be there when he can't be. A nurse will check in maybe 3x a week but on call 24/7. Now is the time.
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