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crash course on medicare hospice :(

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crash course on medicare hospice :( Empty crash course on medicare hospice :(

Post by redpill Sun Jul 18, 2021 5:38 pm

Sun Jul 18, 2021 5:13 pm

in May, my mother's dementia progressed to the point that she is no longer able to swallow, as well as losing control over her bladder and bowel.

Sad

In the years leading up to May 2021, I've mostly been feeding her Ensure, or whatever was on sale from Walmart. I would also chop up her pills in tiny pieces using a pill chopper.

In May 2021, she couldn't swallow and so she didn't eat She also mostly stopped talking, which remains the case.

I took her to the ER of a local hospital. There she got evaluated by a team of physical therapists, speech therapists, GI doctor and neurologist, and got CT and MRI scans.

They were also able to confirm my mother has mutism, and inability to swallow. She got a PEG tube. neurologist and radiologist said her dementia and brain damage is terminal.

She was evaluated for inpatient hospice but failed to meet Medicare criteria, which I have learned as expected death within days, which proved correct as my mother is still alive.

So i learned something new.

Suddenly I got phone calls and someone called me and offered me assistance, paid for by Medicare and I said sure, why not.

My mother was discharged directly to my home, but this company provided me with a special bed, food for feeding tube, Glucerna and Jevity from Abbott, and diapers and other supplies.

Chuck bed sheets are amazing i must say.

I got phone calls from 6 companies, and i now know that there are at least a dozen or more hospice companies in my city, paid by Medicare.


So since mid June a nurse and a bath aid has been visiting my home.

I thought it was okay

I mother has bleeding in her urine from the catheter and I want to take her to a urologist to have that examined.


this is where I got a rather disappointing lesson.


the company told me that if I go to the ER, primary care doctor, urologist, dentist or any such assistance, I will get kicked out of Medicare hospice, and all durable equipment such as a mechanical bed they provided me with will be returned and all further services will be stopped.

They made it clear to me this is a Medicare rule. Under hospice, medicare will not cover any type of life prolonging service Sad

several of her meds such as blood pressure and blood sugar (diabetes) will also no longer be offered.

Again the intention is my mother is to die. pale

I have thought well maybe I could pay for these services out of my own pocket, though I imagine it'd be expensive.

My mothers primary care doctor bills insurance $190 for a 15 minute visit with primary care doctor. My copay is 0, but this was before hospice. Not sure what I would have to pay. Under hospice Medicare will no longer pay for primary care visits or medication.

they do pay for nurse visits and unlimited diapers, chuck sheets, gloves, and tube feeding formula.

I did not know this nor of this until like within the past several weeks. No

the nurse works with a doctor at this company, and said every 90 days they have to give a status report to Medicare, and that the usual expectation is that on hospice the victim will die within 6 months.

but if she gets say a heart attack, no ER visit paid by Medicare, she's supposed to die pale

there's a new drug for Alzheimer's Biogen Aducanamab, but clearly if my mom were to take it she'd be kicked out of hospice.

so that's what I learned in the past several weeks. No

I wonder if you're like 25 with a fatal pancreatic cancer, do you get Medicare hospice? Suspect

if only I had known.....

in February 2021 I took my mom to the dentist for xray general exam and the dentist told me she has cavities and I set the follow up appointment in June, but by June I took her to the hospital for inability to eat.

now, she is on hospice, Medicare won't cover dental visits, and will kick her off Medicare if I do.

Medicare doesn't really cover cavities though, but obviously what I should have done had I but known is taken her to a dentist in March or April, and have the visit partially covered. And a urologist, for blood in urine, then took her to ER.

I have thought how much would I have to pay for out of pocket for the bed, which is water proof, and easy to clean feces from , and diapers and Jevity brand tube food, and nurse for the urinary catheters to get off of hospice.

So these are some of the things I learned. Obviously if i knew hospice was like this, I would have in March, April, and May
2021 taken my mom to all these services first. I would have taken her to dentist, urologist, primary care then.

I didn't predict however by the end of May 2021 my mother would lose all ability to swallow.

there is some sort of growth in her bladder that causes bleeding into the catheter. if I get a urologist to look at it, Medicare will kick her off hospice.

No


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Post by BraveHeart Sun Jul 18, 2021 6:17 pm

This is terrible for her and for you. Sorry to hear of it.
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Post by redpill Sun Jul 18, 2021 10:42 pm

BraveHeart wrote:This is terrible for her and for you. Sorry to hear of it.

thanks for your sympathy. I don't believe we've ever met.

apparently everyone on Medicare hospice gets the same treatment Sad

I also understand, that if my mother were to miraculously improve, or anyone else who improves, gets kicked out of hospice, but regular Medicare applies.

I am just learning this now.


I spoke to an elderly person whose parents also had this and apparently in the 90s and earlier, Medicare hospice wanted you to die within a few weeks, and that apparently has been extended now to 6 months.

my mom's decline though has been rapid, last year in July 2020, I was taking her to a fitness center had an indoor a/c track, about 7 miles away from my home, and we walked the indoor track, and she was able to drink Ensure.

in 1 year's time, she lost ability to swallow and her ability to walk is severely impaired and she is mute, last year she could say simple words.
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