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Old 11-30-2011, 04:13 PM
 
Location: East valley
2,882 posts, read 3,088,871 times
Reputation: 3801
Default You don't have to be terminal to get hospice

I always thought you could only have 6 months to live to get hospice services. Not true. When a person is in "decline" and has Medicare, they can get all sorts of help including equipment, walker, wheelchair, diapers, a home health aid, an RN checking on you and your meds and doctor bills covered. This was explained to me by a hospice rep here, because my mom MIGHT be going to an assisted living facility. She is NOT terminal. She is 101, but has alot of life left in her. She is in decline. Meaning, she isn't as sharp as she used to be, she uses a walker, she is sometimes incontinent, she takes meds, and she has a little dementia. Her diagnosis is gout.

I understood that she can get these services either at home or in a facility. Where did this idea come from that you had to die within 6 months? The rep said people go in and out of hospice all the time. What?? They get better and don't need it. This is incredible. Its a little known service provided by Medicare and I had no idea.
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Old 11-30-2011, 05:20 PM
 
Location: Brevard, NC
165 posts, read 677,386 times
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I imagine people get that impression from the hospice itself. I know when I spoke to a rep from the local hospice, I was told it was for terminally-ill patients who were not expected to live more than 6 months. The hospice web site has the same information.
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Old 11-30-2011, 06:20 PM
 
Location: Mostly in my head
16,097 posts, read 28,842,932 times
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I think the services the OP is talking about have always been available but that is not hospice. It is billed differently. My mother had those services when she was housebound but definitely nit terminal.

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Old 12-01-2011, 05:54 AM
 
Location: Wallis and Futuna
11,218 posts, read 15,160,053 times
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There are two different uses of the word "hospice." One refers to a Hospice Facility..which is an end-stage medical care facility that exists to ease a terminal patient's last few months (or hours) of life, with no attempt to save it, and every attempt to stop pain and provide comfort.

There is also "hospice equipment" which are all the equipment and medications that are typically used to provide end-stage patients comfort and dignity - such as pain meds, shower bench-toilets, bandages, wheelchairs, adult incontinence pads (diapers), etc. Nurses who provide the service of applying these types of equipment to the patient are considered "hospice workers" even if they are not working in a Hospice Facility.

In-Home hospice care is not the same as a Hospice Facility. It's a very confusing difference to most people. The facility itself -is- very specifically and exclusively for end-stage patients; it is where people go to die in as much comfort and dignity as possible.
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Old 12-01-2011, 09:01 AM
 
Location: East valley
2,882 posts, read 3,088,871 times
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Thanks Anon for explaining that. I later looked up "hospice" on the Medicare.gov website and it clearly said you must have 6 months to live and be certified by a physician to that aspect. So I was wondering if this rep in AZ was pulling something off that was illegal. But now it does make sense. Mom certainly isn't terminal, has more than 6 months to live, and really has no disease that is killing her (except her age). So I appreciate your explanation of the two different types of hospice. I think the gov should call it something else, so its not so confusing.
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Old 12-01-2011, 12:42 PM
 
7,331 posts, read 7,515,379 times
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My mom is receiving hospice care, which consists of a CNA visit 3x/week and an RN visit 1x/week, diapers, and all the durable medical equipment she needs. There is also a hospice nurse available around the clock. The hospice organization bills Medicaid $5,000+ per month. My mom lives in a private home where she receives nursing-home level care and it was the woman who runs the home's idea to have her evaluated for hospice. Her diagnosis is "failure to thrive." She has advanced dementia and needs help with all of her ADL's.

She was evaluated for the program two years ago and met the criteria. Then about six months later she was taken off hospice because she had gained some weight and was doing better. Not long after that she got sick and was reevaluated for the program and started receiving the benefits again. When she qualified for hospice care the first time the social worker told me that they have had patients on hospice care for as long as four years.
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Old 12-01-2011, 03:38 PM
 
Location: zone 5
5,942 posts, read 4,749,704 times
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Quote:
Originally Posted by Marlow View Post
My mom is receiving hospice care, which consists of a CNA visit 3x/week and an RN visit 1x/week, diapers, and all the durable medical equipment she needs. There is also a hospice nurse available around the clock. The hospice organization bills Medicaid $5,000+ per month. My mom lives in a private home where she receives nursing-home level care and it was the woman who runs the home's idea to have her evaluated for hospice. Her diagnosis is "failure to thrive." She has advanced dementia and needs help with all of her ADL's.

She was evaluated for the program two years ago and met the criteria. Then about six months later she was taken off hospice because she had gained some weight and was doing better. Not long after that she got sick and was reevaluated for the program and started receiving the benefits again. When she qualified for hospice care the first time the social worker told me that they have had patients on hospice care for as long as four years.
A doctor still has to have deemed their life expectancy was six months though. They don't have a crystal ball, so some patients may live much longer, but they have to say it's reasonable to expect no more than 6 months.
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Old 12-02-2011, 05:47 AM
 
2,403 posts, read 5,319,080 times
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Yeah -

all hospice services - at home, or in a facility - start when a doctor says "Not expected to live more than 6 months".

The key of course is "expected". There are some patients who - on hospice - live for years.

However if something happened to where they actually "recovered" - and therefore were no longer deemed "terminal" - (spontaneous cancer remission, etc..) - they would go off hospice.

Also - its fairly important to note, that once you go on hospice, while a lot of things are covered - other medical conditions are not.

Lets say someone goes on hospice because they have end stage congestive heart failure. While on hospice, they are diganosed with early stage bladder cancer. In general - they will not be treated for the bladder cancer.

If they decide to treat the bladder cancer - they will go off hospice.

Of course they can always go back onto hospice, by getting recertified.

Medicare is great, but there are a lot of regulations and they are very serious about following them. In order to make the money that is there, go as far as possible - I am glad they do.

But it does mean that its important to really read on the medicare.gov site and understand what the patient is and is *not* entitled to.


Now medicaid - that's a whole different game.
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Old 12-02-2011, 08:26 PM
 
233 posts, read 319,019 times
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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?
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Old 12-03-2011, 07:25 AM
 
Location: zone 5
5,942 posts, read 4,749,704 times
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I'm very sorry for your loss.
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