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PhxBarb, yes, you do need to have a doctor certify that it is expected the patient has less than six months to live. Based on your mother's age and the fact that her health is declining, I am willing to bet that the hospice feels that is sufficient enough to at least talk to her doctor about whether or not she might qualify for a hospice-appropriate diagnosis and certification.
Some hospices are aggressive about enrolling people, even when it is not appropriate. Although on the other hand, a good hospice nurse will pick up on those early signs before anyone else will. Ideally, a person would enroll in hospice early enough that they (and the family) can make use of hospice benefits, well before they are actively dying.
There is something known as the "hospice cure." I've seen it many times. Someone will be really ill, not expected to live at all...they get the extra services and TLC from a great hospice team, and because of that (and the grace of God, if you believe), the person's condition improves, and they come off of hospice services. It happens. Don't count on it saving your loved one, if your loved one is dying, but it happens.
It is true that in order to be eligible for hospice, one must have a qualifying terminal diagnosis, and must be expected to live for no longer than 6 months. That said, even experienced physicians often make inaccurate predictions regarding one's mortality. While under hospice care, an individual generally cannot receive any treatment that is intended to improve his or her condition; all treatment must intended to keep the patient comfortable. After 6 months have gone by, the hospice agency can seek approval for another 6 month period, if a physician certifies that all the criteria are still met. If the patient is still alive, but the doctor does not expect him or her to survive for another 6 months, hospice care can continue. Theoretically, this cycle can be repeated over and over again.
One advantage of hospice is that all most, if not all, medication and equipment that the patient needs is provided by the Hospice company. Medicare pays the company for the care, and the company is required to provide everything that the patient needs (this is generally true with private insurers as well.) This alleviates the family from making trips to the pharmacy, arranging for delivery of equipment, etc. This is a contrast to Home Health Care and other in-home services. Patients who are receiving these types of services must obtain and pay for medication and equipment separately.
Great grandmother passed away last night, she was sent home from hospice and passed a few hours later... just thought I would share it is kind of ironic eh?
I am truly sorry. Was she wanting to die at home ? Or was it someone elses decision to have her go home?
I hope I get hit by a car when its my time. Goodness knows, I don't want to live to 101, like my Mom.
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