Respite vs Hospice

Wilted Daughter

Does anyone know the specific differences between respite/hospice or has used either service. It is my understanding that Medicaid pays for respite for a limited time in a nursing facility and Hospice (which may include respite services) is coordinated by the Hospice facility and PCP and paid for by Medicare.

I have requested information from the nursing home, hospice and requested a referral from mom's PCP. I need a short-term break where mom is out of the home...I don't care what it's called.

Feedback/information will be helpful. Thank you!

Merry Christmas

Mint

Hopefully someone way more knowledgeable about this than me will show up here.  Believe from your description it would be respite that you want to inquire about.

Quilting brings calm

Respite is temporary care  at a facility to relieve the caregiver.  It allows the caregiver to go on  vacation, get surgery and recover, get a break for a few days. Up to 30 days.   Often the caregiver uses it as a means to ease the dementia patient into a facility permanently 

Hospice is about the care the patient needs.  Either the patient is expected  to die in a few months, or is far enough along in the dementia journey that extra Help are needed.  Pain meds, hospital beds, visiting nurse, bath and feeding aid, etc.  it’s usually provided for the rest of the patients life.an evaluation is needed to make sure the patient is at that point and stays at that point.  Some dementia patients go back and forth Between being on it and not.  Most medical procedures stop once you go on hospice.  Can’t be doing treatment to prolong things, such as cancer treatments.    Most hospice is done wherever the patient already is, but some hospices have their own facilities. 

Cynbar

Hospice patients (already on hospice) are entitled to a 5 day respite (how often varies, usually a couple times a year, can be a little more often for specific reasons). The hospice staff arranges it, usually in a local nursing home, continues to supervise while there, and pays for it (no extra charge for the patient.) For someone not on hospice, it is possible to arrange a respite on your own, for variable amounts of time (many facilities have a minimum of 2 weeks.) This could be in a nursing home, assisted living or memory care, depending on who has space. It is usually private pay, although someone already on Medicaid might be able to go that route, as long as the facility accepts Medicaid patients and is willing and the patient meets qualifying criteria for that level of care. If not on hospice, the family contacts the facility and makes all the arrangements. Medicare does not pay for respite stays. I arranged a 2 week respite for my DH when I had hip surgery, it was pretty easy to do. My first choice MC had space, gave me the paperwork I needed to get the PCP to fill out, I got him a TB test and wrote a check --- that was it, and it went fine.

Rescue mom

Respite care is temporary care; a few days or weeks, so the caregiver can get a break for (usually) a needed vacation or medical procedure.

Hospice is a full program/service for care, that’s free of direct costs. Mostly for terminally I’ll patients, and sometimes for dementia. Patients are assessed by the hospice(s), which then decide if they qualify. Hospice costs are paid by Medicare. 

Most hospices include a week or so of respite care, no or little charge, for hospice members. So in that sense, Medicare does pay because Medicare pays for hospice.  (In my area, hospice respite also depends on available space, and there’s not much. My mom was in and out of hospice for years with dementia. I still had to pay for respite care because hospice had no space available).)

I’ve never heard of Medicare paying for general respite services (outside hospice), and I’ve looked hard. Medicaid may pay for some, if she’s on Medicaid and if you can find a facility that accepts Medicaid and does temporary respite care.

If she’s not on Medicaid, and not in a hospice, and you’re just looking for a place where she can stay a few days to give you a break, you will almost certainly have to pay out of pocket—unless you get her in a hospice that provides respite. 

Many facilities will allow respite stays for anyone regardless of hospice or Medicaid, but you have to pay. Often a 1-2 week minimum is required, and the rest of what Cynbar said. I have paid for home respite care for my DH with Alzheimer’s.

And if you need a skilled nursing facility, that’s a whole different thing. But since that’s not mentioned, I’m thinking it’s not a factor.

Wilted Daughter

Thank you all for your responses. I'm using terminology I barely know (hospice, respite). Any service selected will probably include skilled nursing to address her conditions (diabetes, high blood pressure, heart condition, medicine, and dementia management). She can not be left alone for long periods and she is limited in self care along with her mobility issues. 

I reached out and inquired directly to the nursing center, hospice, and Elder Services. Elder Services' case manager said they help with respite through Medicaid (Frail Elder Wavier, etc.), by providing evaluation/approval from a nurse to ensure mom meets the criteria for Medicaid paid respite (we'll see...). 

Thanks again!