What Is Hospice, and When Can Someone Get It Under Medicare?

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excellent article overall! Answered my questions clearly and in detail. I will use the information in this article to find a Hospice Service for my father in CT immediately.

my fathers is in a skilled nursing facility we are currently waiting to be transferred to veterans state nursing home in land o' lakes , fl his dr at the ctr has asked me tol get him on hospice, his medicare coverage for skilled nursing maxes out the 19th of this month, he does however have tri care for life since dad is a Korean war veteran how do i get this started and how do I know which is the best and covered under medicare and tricare

Hi this is Linda again....what I meant to say is that Hospice will only be able to give 90 minutes on weekday mornings (total for the week)

My mom is 90 years old and is in the severe/end stage of alzheimer's. She is being cared for at home by my 84 year old dad (not in great health). She is in hospice care but they've told my dad he can only have 90 minutes of help during the week and none on the weekends. Mama is now basically bed-ridden. She cannot walk, talk (only gibberish), she is unable to do anything for herself. She cannot follow any directions - like lift your arm move your leg. She needs help with eating and drinking and needs complete help with bodily functions....toileting, vomiting, dressing, bathing. I help whenever I can, so that he can go and do his shopping and go to the pharmacy, BUT he is rapidly approaching BURNOUT. I'm very worried about him. He is not sleeping at night because of my mom moaning, waking, vomiting. We live in upstate new york. Is this true that Hospice can't provide anymore than 90 minutes a day, five days a week? He can barely lift her to change her diapers and has hired another aide to come in in the evenings (weekday only) To help get her toileted, changed and into bed. I pick up the evenings on the weekend and give him respite tues & thurs. so that he can have some respite and can go to the grocery store, the bank and all other necessary outside chores. He truly needs more help! Can you help us?

I wish my mother would go into hospice, but the problem is, my mother will not accept the fact that she is dying. Therefor, my mother has be VERY DIFFICULT to take care of, and it has been in and out of hospitals, because she will not stay in there for more that 1 to 2 days.My mother never went to rehab to learn how to change and deal with her bag. My mother had breast cancer years back, and now it is in her bowels. My mother hates hospitals, her kidneys are failing, and she did nothing about it, because she don't want to stay in the hospital. Now she is kidney failure. Also, it was hard for her to even go for a scan. finally she had one done. My mother won't say much to me about it, only that there is one tumor in there growing that is causing her pain. My sister told me our dad told her that cancer is all in her bottom stomach area. I helped her at the beginning of all of this, but had to stop to take care of my husband who had his own operation. My mother wants me back, but excuses my sister from helping her. My mother wants me and her sister to be the ones to help her. My mother refuses any other help, and will not have a nurse in her home, and will not accept hospice care. My 85 year old father is taking care of her and changing her bag. My mother said to me once, the doctor takes of putting me in hospice, talked to me like I am dying. I am not going to die until I am ready to die. My mother is nothing but bone, and weighs (last I heard) only 72 pounds. My mother is blocking up again too! My mother throws up after she eats. My mother has sat on the couch not wanting to go to the hospital, and was in urgent need of water, and finally talking weird before she would agree to go to the hospital. my mother before she finally got her scan, was saying she has the stomach flu is why her stomach was hurting her. I guess it was her way of coping with all of this. My mother would run to her primary care to avoid going to her cancer doc to get meds, so she can stay out of the hospital. Last time she was in the hospital, they tried to help her, wanting her to see a kidney doctor while in there or to give her blood. My mother just lay in her hospital bed bucking all help, and finally they released her.

If medicare and or the state is paying QSP's for in home health care, will this discontinue if hospice is involved?

How does this work with people with dementia/Alzheimer's? Do they stop taking all dementia/Alzheimer's medications if they go on Hospice?

I need a live in hospice facility in Long Beach for my brother who has incurable cancer. Is there such a facility outside the home in Long Beach? If so can you spread some light on the facility for me?

was vey good, right now nothing would help.

Thank you for a well written informative article. My experience with a terminally ill parent and home health care/hospice was not positive, perhaps because these conditions come on fast and leave little time to research and psychologically adjust. Our visiting nurse came in saw death was eminent and left. The doctor's office offered support/encouragement and said they would keep the phone line open. Through the years, I have cared for cardiac and cancer conditions. Now I will be tackling Alzheimer. At least this condition gives me a learning curve. I hear good and bad experiences but knowledge on what the system offer and does, prior to needing it is the best wisdom.

It's so important to learn as much as we can, from this pages, it's so helpfull thank you so much maria aleman

Thank you for pointing out that choosing hospice care is other than 'giving' up. You still receive 'palliative' care (comfort care). This is what I will choose when my time comes, and it is in all my paperwork as well.

The comments are also very good.

Very informative. Thanks!

There is Hospice and there is Hospice! In between ther is Palliative care all of it depending on where you are in terms of your health and ability to care for your self. If you are doing better Palliative care where ever you want it can be available but it is intended to monitor and identify in advance any new problem. The "team" provides a tremendous amount of in sight and direction for thr family and the patient. If he gets worse for a while and with the hope they can keep him out of the hospital Hospice can be the next step but not the final step because that "team" is working to improve the patients well being. People need to become aware of the differences in Hospice and the benefits if you qualify. It too is paid for.

Thanks for the article....I only knew that hospice was for the dying...no details. Thanks again. Your articles are certainly helpful. s

Yes,I had no insight about hospice care other than it was for the dying. Thank you!

Hi the kingbird­, Thank you for your comment. Sorry to hear that we weren't able to answer your question in this article. If you'd like, you can post your question in our Ask & Answer section, here: ( http://www.caring.com/ask ). I hope that helps. Take care -- Emily | Community Manager

I still did not get an answer as to whether Hospice could turn down a patient due to the cost of the patient's mantenance medications. Without my Lovenox blood thinner, I would be comitting suicide to intentionally try to live without it. That would be the same as just quitting taking all medications at all. Luckily, I have found a primary physician that is on the board of the local Hospice to care for me. He uses the best available practices of normal care, gets me a pain medication that is sufficient for now, and trys to manage the other problems as they come up. I still think that surgery to take the massive fluid packs out of my abdomen would make me more comfortable, but the surgeons won't touch me for fear that I would not survive the surgery. It would be a lot more humane to try to take them out than my having to live with them from day to day. They currently have my urianry system in such a pressure that I have to have a drain line 24-7 from now on, and movement of my bowells is a terriable pain that is barely tolerable!These "packs" are like tumors taki9ng up space in my abdomen so much that they are clearly visable to the outside of my abdomen.

I agree with the lackluster experience of home hospice. My mother passed away three years ago of pancreatic cancer. We were so unprepared for what was facing us, giving the medications, baths, etc. Now my dad has been told he has pancreatic cancer and we are facing the same situation. We are urgently looking for a hospice facility in our area but there's not very many and the hospital is pushing their vendor of choice which is an in home hospice. I guess we are wimps but we can't go through this again.

I had read about how great hospice was and what a great experience everyone had. Our experience was lackluster to say the least. Mom was put into hospice while I was out of town..little did we know she would decline so rapidly. As a result the nurse would come to the apt and fill the "sticks" of morphine but it was my best friend who had to administer them. Something she never expected when i asked her to come and check up on Mom. And when Mom came up out of her morphine coma... the hospice nurse, on the phone, told us we were crazy, my Mother was in a coma...like H she was, she was looking me straight in the eyes, up on her elbows, choking on her own fluids and asking for help. Luckily the nurse from her independent living facility was in and ran to her side and administered the proper increase in morphine Mom needed. Hospice for my family was incompetent at best. They left a group of unskilled family and friends to tend to Mom, Mom's morphine was running out and we called at 5 AM, by 9 AM we had heard nothing back, by 10 we were out of Morphine and FINALLY at 11 the hospice nurse arrived.... it was one of the most traumatic events I had to face over the last 2 1/2 years of Mom's non-smokers lung cancer.

As a Hospice volunteer, for a number of years, I have experienced the wonderful care both the patient and the families have received. One lady had just had major surgery, I asked her daughter to speak to her general practitioner about Mom's illness and instead of more surger the next day she went home to her loving family. A grand daughter involved Her in the planning of her wedding and she enjoyed all the attention by family members. Later, her other, who was an RN became the director of the Hospice. At the end of our lives many people want this type of interaction, whereas for others they want the steral atmosphere of the hospital. My job as a Discharge Manager & Social Services Manager brought me even more understanding of Hospice. The patient had advanced CA, was moved to a the hospital close to his home for Hospice care. While speaking to his wife she told me this was the first time she would be living in their home alone. I suggested Life Line which would contact a neighbor if she needed help.

Hi the kingbird­, Great question! If you'd like, you can post your question in our Ask & Answer section, located here: ( http://www.caring.com/ask ). Take care -- Emily | Community Manager

This is really a question to the finances of Hospice. I am terminal with congestive heart failure. My organs have begun to slow toward stopping working. I take a med. called Lovenox (a blood thinner) and when they came upon this medication in my list of meds., they all of a suddent couldn't take me into Hospice because they thought I would last longer than 6 months. In truth, the biggest drawback to my getting into Hospice, was the cost of that medication (over $1500 per month). I understand that Hospice has to pay for all medicines while in Hospice. Is this correct? Are they allowed to pick and choose their patients like that?:

My husband is in Hospice care now in a memory support unit. He is receiving excellent care and it has been a great relief to me. It has also caused the staff in the facility to step up their efforts now that hospice workers are in and out at odd times. He has a terminal illness, Lewy Body Alzheimer's. He probably will not die in the the 90 day period but the Lewy Body makes the physical decline very rapid. After a hospital visit and two emergercy room visits, where after 4 hours each they found nothing, I did not want him to go through that again. I just wanted him to live out the rest of his life in as much peace as possible.

That comment is correct. Aides cannot administer medications. They can however remind pts to take their oral meds. Also, in regards to how long hospice continues, patients sign up for six months at a time. If the pt needs to continue longer they can sign up again. In some cases pts can be on hospice services for several years. On the counseling services, hospice will normally assist the family, namely the spouse or significant other for 13 months following the death of the patient. They contact family on special occasions such as holidays, birthdays anniversaries etc. This is the time when the family need extra emotional support.

On page 2, under Aides, you are WRONG that aides will administer pain and/or other medications, or else they are violating the law !! In any state, only licensed nurses are allowed to administer/prepare/give any medication, especially pain medication. PLEASE correct this !!