Hospice question(4)

Marie67

I've read many post where a lot have been on hospice a couple of years. A friend told me her father with dementia was on hospice for over 4 years. I thought life expectancy had to be around 6 months in order to qualify.  Has anyone here had hospice for LO over 2 years? At my husband's last (PCP) doctor visit, doctor mentioned I may want to start considering hospice. Yet he has not mentioned anything about my husband only making it a few months. And in fact, neurologist says it could be several years before the end.

Ed1937

The short answer is yes, we have members who have used hospice for 2 years or more. The six month rule is a thing of the past when it comes to dementia.

mommyandme (m&m)

Six months is a guideline for a lot of illness but dementia alone is not as predictable as some of the others.  1.5 years here.  Have the evaluation, if they admit him, the level of support they can  provide will likely be extremely helpful. It was for us.

Battlebuddy

   We are on a year and 9 months and just renewed. So we will likely make it to 2 years. For Hospice it’s all about decline. I would have them come out and evaluate. We had an evaluation 9 months before he was admitted. He didn’t qualify then, but when I called them 9 months later he was already in the system , and they used the previous stats to document decline. 

  Hospice has been wonderful to us, and the weekly talks with the nurse  have been so helpful, as well as the supplies and bath aides. 

Ed1937

xx

fayth

My spouse received hospice services for almost 2 1/2 years before he died.   Medicare requires recertification every 2 months. He continued to qualify because he kept declining, even though the decline was very slow.   Hospice was incredibly helpful.  With their help I was able to care for him at home up until the final year.  They continued to care for him the last year when he was in memory care and that gave me great peace of mind.   I encourage you to get an evaluation and get services as soon as they are available to you.  FYI -  one hospice agency in our community would not accept him for services.  Another one accepted him right away.  So, if your LO is denied by one hospice agency, try another.  Or, if your LO is not accepted right away, they may be accepted before long.

harshedbuzz

My late MIL, who did not have dementia, was on hospice for 5 1/2 years.

EVERYDAY

fayth wrote:

My spouse received hospice services for almost 2 1/2 years before he died.   Medicare requires recertification every 2 months. He continued to qualify because he kept declining, even though the decline was very slow.   Hospice was incredibly helpful.  With their help I was able to care for him at home up until the final year.  They continued to care for him the last year when he was in memory care and that gave me great peace of mind.   I encourage you to get an evaluation and get services as soon as they are available to you.  FYI -  one hospice agency in our community would not accept him for services.  Another one accepted him right away.  So, if your LO is denied by one hospice agency, try another.  Or, if your LO is not accepted right away, they may be accepted before long.

May I ask which part of Medicare will pay for Hospice, is it Part A?

Thank you.

Caring4two

Medicare hospice details

 https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=&ved=2ahUKEwibzfThkof-AhXDjYkEHW1rBy0QFnoECA0QAw&url=https%3A%2F%2Fwww.medicare.gov%2FPubs%2Fpdf%2F02154-medicare-hospice-benefits.pdf&usg=AOvVaw29Gt3_KOHWUZd6EbRYHCl9

Marie67

Caring4two, thank you so much. Best information I've seen. I hope others check into this as well.

fayth

Caring4Two posted great information.  Also,  hospice agencies will know..  That's how they are paid.  Best wishes to you.

elainechem

In my case, my hubby did die at almost exactly the six month mark of being on hospice. It came as a complete shock to everyone. Literally no one expected him to die then. They were preparing to recertify him for another three months. Then he had a major seizure and died eight days later. This disease is very unpredictable. I have heard many cases of people with dementia being on and off hospice for years before they finally pass.

Jo C.

It is Medicare Part A that covers Hospice. If one has a Medicare Advantage Plan, the plan itself is not responsible for Hospice coverage; that is managed out of plan by Medicare and it will be seamless with you not having to do anything and the patient will still continue to be covered by the Advantage Plan.

While six months of life is the measurement set forth by Medicare, that is really very outdated, especially when dementia is the primary problem issue. Initially when accepted into service and placed on Hospice, the service will be "certified" for two 90 day periods; the patient is assessed by Hospice RNs for continued need and re-certified. After that, the cert periods happen every 60 days on an unlimited basis if the patients continues in decline.

It is also a blessing in that Hospice will also follow a patient in a care facility should placement become necessary. That being said; not all Hospices are alike. Some are far more beneficent than others. Should one Hospice not accept a person as a patient, it is good to call another.

While a doctor's order is required to start Hospice services, it does not take a doctor's order to assess a person for hospice care. You can make Hospice calls for assessment for service yourself. If accepted by Hospice, the RN will then call and obtain the doctor's order for service.

For my Loved One, (LO), I contacted three Hospices and asked to speak to the Supervising RN. I was able to ask about their services, their philosophy in care, and discuss any issues or patient concerns. In that way I was able to determine which Hospice sounded like the better fit. In my experience, both professional and personal, I have found the larger Hospice organizations better able to provide services and be more easily available for problems than the smaller Mom and Pop entities.

Hospice can be awesomely supportive not only for the patient, but also for the family. Let us know how you are doing and how things are going, many of us have been in like situations and we understand the dynamics and concerns.

J.

SC2SUNSHINE

https://alzconnected.org/discussion/comment/167562#Comment_167562

This says 6 months or less, how recent is this document?

Ed1937

"If you live longer than 6 months, you can still get hospice care as long as the hospice medical director or other hospice doctor recertifies that you’re terminally ill. Hospice care is given in benefit periods. You can get hospice care for two 90-day benefit periods followed by an unlimited number of 60-day benefit periods. A benefit period starts the day you begin to get hospice care, and it ends when your 90-day or 60-day benefit period ends. At the start of the first 90-day benefit period, your hospice doctor and your regular doctor (if you have one) must certify that you’re terminally ill (with a life expectancy of 6 months or less). Important: At the start of each benefit period after the first 90-day benefit period, the hospice medical director or other hospice doctor must recertify that you’re terminally ill, so you can continue to get hospice care. Once your hospice benefit starts, you don’t need to “re-choose” hospice care for each new benefit period. "