My dad, 94, in AL with not much other than congestive heart failure being medically wrong with him. He's still in fantastic spirits. He gets around in a wheelchair, mainly because he stopped getting PT (didn't want it anymore, which I get). He refuses to sleep in his bed (I've purchased 4 dif beds, none were to his liking), so he sleeps in his power lift chair. At 94, I figure he gets to do whatever he wants. I was curious about hospice. When I asked the nursing coordinator at his AL place, she said he would be a candidate, and Hospice swooped right in and are taking care of him now. At first, I thought Hospice was for people who were, well, on their death bed with just a few days to go. Has something changed??? Thanks.
There is something called Medicare Care Choices Model that apparently being run experimentally by CMS. It avoids the choice of giving up curative care while retaining the ability to have Hospice.
When you say "not much wrong except..." CHF may be slow but it is often sure. Perhaps ask your father's permission to go through his latest test results with his primary physician?
Hospice eligibility requirements-
In order to be eligible to elect hospice care "under Medicare", an individual must be entitled to Part A of Medicare and certified as being terminally ill by a physician and having a prognosis of 6 months or less if the disease runs its normal course.
In order to be eligible to receive this service, a beneficiary must:
be determined to have a terminal illness (which is defined as having a prognosis of 6 months or less if the disease or illness runs its normal course;
not have made a hospice election, and
not previously received the pre-election hospice services.
JoAnn,
The hospice I worked for (up until this year) had the Medicare requirements that a patient had to be declared by their doctor that they had 6 months or less to live.
That can give the doctor a lot of freedom and some have prescribed hospice (paid by Medicare) for patients (as seen above) that GREATLY outlived the 6 month mark. The docs know the the family could use some help and this is one way to get it.
Maybe the requirements are different in other states but I think Medicare is national.
I suppose you could pay for the services if you didn't have the doctor's order (?) but I've never heard of anyone doing so.
In the case of dementia this can be tricky. Dementia is fatal. But it can go on and on for years. At what point is death likely to occur within 6 months? There are generally other indicators, like weight loss, swallowing difficulty, etc. People with dementia can certainly have hospice care, but not based simply on the diagnosis of dementia.
I've had a loved on on hospice in home and another in an NH. In neither case did hospice provide daily care. Supplies and equipment supplied by hospice are great! And a nice savings. And no red tape to get them. Hospice care certainly does not add to the recipients costs. But I'm not sure what services AL provides that you could stop paying for once Hospice is in the picture. Could you give an example?
I did not get an aide at home when my husband was on hospice. I could have had a volunteer a few hours a week. I kept the PCA we already had. The nurse visited a couple of times a week. It is a great service, but I'm not sure it replaces any facility charges. It is additional care; not replacement care.
Is this hospice company affiliated with the AL facility? I have a feeling there's a cozy relationship.
My husband was on hospice care 5 weeks in our home before his death. I wish I'd called them in sooner. It was a great help to have them involved.
My mother was in a nursing home when her hip broke. It was inoperable, and the palliative care nurse predicted she had less than a week to live. She returned to the NH on hospice care, which was a nice bit of extra attention. After three months they discharged her from the program, since she no longer seemed to be near death. She lived another couple of years.
Many people are on hospice only at the very end because their loved ones don't realize it is available for much more than the actual end. It is supposed to be supportive and comforting for the months at the end of life.
The program will have a chaplain, social worker, and nurses that you can talk to about any questions or concerns you may have. And feel free to come back here anytime!