It seems to be so area specific, in our county, any form of dementia was not a qualifying event.
I also dealt with two different hospice experiences in a different county and found them to be much more helpful. Don’t get me wrong, most of the individual helpers were lovely, it was more the administrative setup which I did not enjoy in my home county.
The Hospice Medicare guidelines have always said that patients need to have a life limiting illness where life expectancy is estimated to be six months or less, and the patient is no longer seeking life prolonging treatment. Physicians need to certify that a patient is “hospice appropriate” and notoriously it’s done way, way too late in the process.
In broad strokes, picking a community based, not for profit program tends to be better than a large, for profit systems. Often hospitals won’t even tell families that there are options and they’ll just refer to their own program. Many times those aren’t the best.
We’ve had hospice care for loved ones all over the country. There was only one that was sub par. When done well, it can be a big support to the family and help keep the patient as comfortable as possible.
My mother in law in a memory care unit only became eligible for hospice when she deteriorated to the point where she was expected to not last more than 6 months. She lasted for 13 months on hospice and actually improved initially, but had to be reevaluated regularly to remain on hospice. So glad you are feeling supported @cinnamon1212 .
I should have been clearer – to qualify for hospice with dementia, a patient also needs some co morbidity, and an inability to carry out the daily tasks of living. And yes, they are recertified periodically. Our nurse told me of a patient that’s been on hospice for the past 3 years.
Anyway, I had no idea my Dad might be eligible and it’s a tremendous benefit, so wanted others to know about it.
My dad had dementia/Alzheimer’s and was living in Memory care for 4 years. He was hospitalized (which made him extremely agitated) with UTI/Sepsis and the hospital suggested hospice. He mostly recovered and ended up having cardiac arrest while eating breakfast a few months later. The extra supports that hospice provided, especially during COVID were very helpful. At first the hospice staff didn’t listen to the Memory Care staff, but eventually it went smoothly.
Would it help to find your father’s financial institutions by looking at his last tax records? That might be a place to start looking. Did he have an accountant?
I have trained with hospice and their biggest frustration (with financial consequences for them no doubt!) is that people think death has to be imminent. Most people use hospice their last few days, but it is possible to go on hospice with dementia, it is possible to go on and off, and it is possible to be on for years, if you continue to decline.
Also it is not true that you cannot diagnose and treat medical conditions. Hospice Medicare, which is separate from Medicare, covers the care related to the condition for which you are on hospice. Simultaneously, regular Medicare plans will cover anything NOT related to the diagnosis for which you are on hospice.
That said, hospice personnel may apply some pressure to stick with comfort.
It is also possible to go off hospice for a day to get a procedure then go back on.
ps I was told recently that people can go on hospice for several reasons at a time and they will pick one as the primary hospice diagnosis. Each time my mother has been on hospice (3 times) she did have something else going on. Diverticulitis once, anemia once, and she always has a level of congestive heart failure. She has improved each time and that is what takes her off services- if she continued to decline in ANY way she would have stayed on.
They want to send Mom to SNF but we want her in rehab. They say she is not up to hours of PT a day. Ha! My dad didn’t get hours of PT when he was in rehab! We will keep fighting.
The lawyer has his 2016 tax returns - a different accountant did the last few years. So he does have a good idea of where to look, I am sure he can contact the other accountant also.
Oh nooo… just saw a post by ML in say it here thread. Because that thread is a no reply thread, I am posting here. Big hugs ML, and I am so sorry. My mom is still alive. I can’t imagine becoming an orphan some day, but I know it is coming. I really dread that day…
Oh, BB, I saw that, too. Seems like it was sudden for her mom, and after all the ups and downs with her dad’s situation. Hugs to you, @MaineLonghorn
My sincerest condolences to you @MaineLonghorn
Sorry to hear of your mother’s sudden passing Maine Longhorn. How is your father holding up?
@MaineLonghorn Hugs to you and your family; what a year you have been through. Thinking of you and especially your dad.
Thanks, everyone. It was a blessing to be at our cabin with two of our kids when we got the news. It’s a rare occurrence for us to be together up here. I took this photo from our front porch to remember where I was when I heard.
It’s hard to write much on my phone so I will share more when I get home.
@MaineLonghorn im so sorry about the news of your mother’s death. It’s always such a difficult thing but glad you had your family with you
@MaineLonghorn there are some stand alone rehabs that are much better with younger patients. Rehab facilities that also have skilled care in their facility (nursing home) can often do better with an elderly person who can improve with rehab and therefore show progress for being counted as rehab versus skilled nursing. Key is having a sizable number of rehab beds so you have FT therapy services in the building - PT, OT, ST. They will work with the patients with repeated sessions and document progress or no progress. If showing progress, can continue as a rehab patient versus a skilled care patient.
I admitted a patient the other day that had been at a stand alone rehab - that same company operated another facility in that city, and she said she got terrible care with the more recent stay. She had fragile skin and was not treated by a wound nurse at that facility. As soon as she was admitted, our wound nurse had major dressing on 3 of her limbs (both lower legs and one forearm).
@MaineLonghorn so sorry for your sudden loss. I hope your dad can stand it. Many warm thought being sent.
Oh @MaineLonghorn, I am so sorry. May her memory be a blessing.
Thanks again for all the condolences. I appreciate the PMs too - I apologize if I don’t get back to you. Getting ready to fly to Austin on Wednesday is a little daunting.
Long story short, she went into the hospital a few weeks ago and they scheduled hernia surgery. She just wasn’t recovering like she should have. She had a bowel obstruction that should have resolved on its own, but it didn’t. They did exploratory surgery about a week and a half ago. They discovered what they thought was cancer but they weren’t sure. That was on July 1 and the holiday weekend delayed results. Early in the morning on July 7, the ICU doctor was still hopeful she could recover. Shortly after that, though, the oncologists told us it was Stage 4 cancer, origin unknown, and it was widespread. She went downhill so fast that Dad agreed they could remove her breathing tube the evening of July 8. They removed nutrition and hydration the morning of July 9. My sister was with her almost non-stop. She stayed IN the hospital bed with Mom Friday night. Mom passed away at 5:58 am CDT on Saturday, July 10.
So the suddenness with which we lost her was shocking, even to the doctors. But as an RN friend pointed out, it’s possible Mom had been suffering awhile and couldn’t express it due to her moderate dementia.
My son and I share a birthday this Wednesday, July 14 (he turns 29 and I turn 59!), and that is the day he and I will be flying to Austin. He has requested Tex Mex for dinner, so we will make it happen. My husband and daughter will fly down on Thursday. The funeral is on Saturday. The three of them will return to Maine on Sunday, but I will stay another week to help my dad move into his new facility - the move was planned for July 22 and he said he doesn’t want to delay it. I called the facility and they said I can use the gym, yay. I’ve lost over 30 pounds and have been working out for three months and don’t want to lose too much ground in my fitness.
Now I’m running around like crazy, trying to get ready to leave Wednesday. So many details to remember, especially since we’re having the interior of our house repainted. I have to help my husband move stuff out of several rooms on top of everything else. Why does everything happen at once??
Hug your parents if you still have them! Life turns on a dime.
