Some Hospices will Grant Extension Periods

Joshbi

I feel I am fortunate that my DW has been receiving excellent palliative care in her Memory Care facility. She has been in MC for over 4 years and is in early Stage 7. MC administrator advised me 10 months ago that DW was “probably eligible” for Hospice admission because of a rather dramatic weight loss, periodic falls/balance issues, loss of most vocabulary, and incontinence. Her PCP at the facility signed off on the consultation order, and DW is now technically under Hospice monitoring by their nurse who visit the MC unit. 

DW rallied for the next few months, ate more (inability to use utensils but staff leaves finger food in her room and/or feeds her), and they are very fond of her. She contracted COVID just before her two 90-day periods (six months) of Hospice nurse visits were up,  and she was automatically given a Hospice extension of 60 days. Then she was granted another sixty days because she was found in her room several times sitting on floor—staff can’t tell if she falls or just decides to sit and is too weak to get up. Apparently, those setbacks were enough to justify the extensions. 

DW walks around the unit constantly and is often animated, so I keep thinking she will  be ineligible for continued Hospice ( or “graduate from Hospice” as the cliche goes), but the nurse told me that if there are continued indications of “failure to thrive” or not “significant improvement”, patients who have advanced dementia are often given extensions. I am writing this because there are so many stories of some Hospices being very strict on eligibility while some find ways to extend eligibility. 

Again, I feel I am one of the fortunate spouses, and am just glad that DW has another set of eyes on her. I am actually hesitant to ask Hospice how many extensions are “normal” for fear of jinxing Hospice monitoring. There are several well established Hospices in my area, and the MC administrator said all were excellent. I was told that if one Hospice doesn’t accept DW—perhaps because evaluating nurse is experienced—chances are another evaluator would be more familiar with progressing dementia and would examine history at MC more thoroughly. I hope this information helps anyone who might think their spouse isn’t eligible for Hospice or is denied coverage. You can always request that your LO be evaluated again, perhaps by a competing Hospice. I am holding my breath that my DW will not suddenly decline, but I am certainly grateful that Hospice is still in place. Blessings to all, Josh 

Joshbi

Re Hospice Entry, middle of last paragraph— meant to type, “perhaps if an evaluating nurse is inexperienced…” sorry for any confusion. Josh