Should we have another hospice evaluation?

MotherOfChins

Hi All,

Three months ago we had a hospice evaluation for my MWA who lives with me and my husband. At the time the nurse said she wasn't ready/didn't qualify.

Over the last two-three weeks she has had some pain and swelling in her knee which she has complained of, as well as her back (she has spinal stenosis, so the back is an ongoing problem). Try as we might, we've been able to help the knee pain, but it has remained swollen and sometimes he lower leg and foot are also swollen.

In the past three weeks, she had more confusion and has nearly quit walking (she has walked with a walker for several years now) and the little bit that she does walk, she has great difficulty and has been dragging her non-swollen leg.

Over the past couple of months she has been eating less and less, and typically only wants oatmeal, bananas and will occasionally eat some scrambled eggs and pudding. She complains a lot of everything tasting bitter. Luckily, little to no issues with swallowing so far.

The last two or three days she has (kindly) asked our caregiver (whom she adores) to go home early and says she's tired and wants to go back to bed - where she is spending more and more time.

I feel like we're reaching the failure to thrive stage, but from the explanation of the last hospice nurse, it almost seems like she needs to be near death to qualify.  We live in a large metro area so I do have other options for hospice groups. 

I have a doctor's appointment scheduled in a little over two weeks for her, but she is incredibly hard to get out of the house now.  Would it be worthwhile for me to go ahead and have another hospice evaluation?  It is so hard to tell with this disease if we are in a major decline or if one day she will bounce back a bit.

Thanks in advance, I greatly appreciate any advice you all want to share.

~ Melanie

P.S. I would say that she was already in mid-stage 6, and she does not have a UTI as she takes a daily dose of an antibiotic to keep lymphedema at bay (residual issue from breast cancer suffered a few years ago). So recent confusion seems more of a decline than from another source.

jfkoc

I would think about another evaluation as well as an evaluation by other Hospices. While they all have bottom line requirements they do differ.

Battlebuddy

I was going to say the same thing. I would call a couple Hospices and also the one that came out before. In my husbands case the second time was the charm because they saw the decline

mommyandme (m&m)

Definitely can’t hurt to get another evaluation, I’d say yes.

MN Chickadee

Yes I would have her re-evaluated.  A PWD may not qualify one day and does a week later, it can change quickly. They look for a variety of factors, especially if there is weight loss. Weight loss alone may qualify her, otherwise a combination of factors related to mobility, speach, lab results etc. My LO did not qualify when we first had her evaluated. The hospice nurse tracked her and checked in every couple weeks until she did qualify. They came out right away when I called for both the first evaluation and the later ones.  If you think you like the current hospice perhaps contact them and explain the change in condition. They may track her changes more closely and she may suddenly qualify now or in a weeks time. And it wouldn't hurt to contact other agencies. They do differ some.

MotherOfChins

Thank you all so much! In my heart I was feeling it was time for another evaluation. I appreciate you all for validating my concerns.

numb

went through the same thing saying my hubby did not qualify. Then a few months later he did. He is progressing very fast now.   Does your Mom have any other health issues for example heart failure, COPD etc?  If so they can evaluate her on that. My hubby did not get accepted for his alz. but for heart failure.  Good luck hospice will be a great help.