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a question has come up:
once someone decides to stop treatment, some medical plans have a 30 day max stay allowed in hospice. What happens if you are still alive after 30 days? where do you get your pain meds if you are kicked out of hospice care?
anyone know?
Is this a health care reform in need of attention???
Cancer Surgery Counseling Pain Hospice care Stomach cancer Pancreatic cancer
I've never heard of a 30 day stay in hospice. I suppose that it would depend on ones' insurance plan. I know that Medicare has a 6 mo hospice coverage, and if one improves and no longer seems to be in the last weeks/months, they can revert back to regular Medicare. The financial office of a hospice organization would be the people to speak with about this issue. They could find out all of the particulars of one's own plan, and may have funds to continue a person in hospice regardless.
How'd the trip to DC work out last month?
My father was part of a not-for-profit hospice where he
never paid for anything out of pocket. I believe they billed his medicare but would have taken care of him without it. As with Oncologists, all hospices are not alike. I'd suggest checking out all hospices that are
available in your area and that would be a great question
to include for each one!!!!
Let us know what you learn!
I would hope that there are hospice's who would accommodate those people whose insurance has expired. I cannot imagine a hospice discharging anyone who needed their care! The thought horrifies me and now has me checking my insurance.
The only thing I know about Hospice is what I read in the late Art Buchwald who wrote a book about his experience with Hospice, "Too soon to say Goodbye". He didn't die as expected and his doctor sent him home. He died a year later.
I hope to use their services some day. I don't know much about Hospice either. Hope we have some people here that have some knowledge to share.
DJ
I have never heard of Hospice leaving anyone, especially for financial reasons. My neighbor had Hospice for a couple of months last Fall and it was never an issue, that they would leave her. My Uncle had Hospice in Fl. for over a year and they were so very good to him and he had no means of paying. I believe those "angels" are with you for as long as you need them, regardless the length of time or ability to pay.
My mother was on Medicare and in hospice care for 6 months. At that time, the patient must be re-evaluated for the need for further hospice care. The hospice people did the re-evaluation and it was accepted. They told me that no one is turned down for additional hospice care, if needed.
Have any of you heard of Hospice care at home? I wonder if that would be covered by medicare. I seem to remember a relative getting hospice care at home for a month before they passed.
A friend of mine has been under hospice care for just over a year now! She originally went into their facility, they didn't think she was going to make it through the weekend but by the grace of God things turned around a bit. She was released from their facility and has remained under their care. Hospice has been caring for her from her home now since last fall. She is a fighter & won't give up!
I used to work for a doctor who cared for quite a few patients in some type of end stage disease, and I was able to set up home hospice for all of them. There wasn't a hospice facility close to us, so home care was all that was available. The only people I have ever heard of being denied care is those whom the doc says have not reached the 6 month terminal stage.
I'm a firm believer in hospice care, and tried to encourage pts to accept it before the last minute so that everyone could benefit from it, not just the pt. They do wonderful things with the family of the pt also, from learning the dying process to how to deal with the grief after the loved one passed.
I wish you luck with the process, and I feel sure that they would not "kick" you out for insurance reasons.
My mom was under Hospice care for over two years. In Jan. 07 her doctor gave her six months to live, so we put her under hospice care. She was reevaluated every 90 days and for whatever reasons she always qualified to continue the care. Everything was paid for, not her assisted living, but all other medications, etc. A nurse came to see her twice a week and and aide came twice a week (to help with showers, etc.). She also had a social worker and chaplain visit weekly. All bills were sent to Medicare and I would receive statements from them but did not have any out of pocket expenses. Hope that helps.
In the UK Hospices are all charities, with some funding from the National Health Service. Most of the funding however comes from the local community. The only way that anyone would be denied in-patient care would be because of a lack of a spare bed as most of them are small organizations. If in-patient care is not available they will support home care, and that may also be the wish of the patient especially at the end of life. Hospices however are about achieving a good quality of life for as long as possible.
My local hospice provides in-patient, day hospice and home hospice care as well as counselling, physio and complementary therapies. There are limits to the amount of these facilities that you can access at any one time, but they are all based on need and are reviewed and extended if necessary. These services can all be accessed more than once as, and when, the need arises.
My experience with Hospice has been that there is no magic deadline where you are given your walking papers. My mother was on it for just a short time prior to her passing, and when the Type A personality in me became worried about how long they would be available, I was assured there were some folks who had been on it for 'years' and they would never throw someone out who was qualified and just hadn't died yet!
My fear is too many people associate Hospice with giving up or being ready to die...and don't call when it is appropriate. I know in my mother's case, she wouldn't o.k. the call until the very end, and at that point there was little comfort they could provide. However, the angels were a Godsend to me!
If you do find there is a loophole in need of adjusting where Hospice is concerned, please let us know!
If you are on Medicare (I can't tell if you are 64 now or when you joined over a year ago), you have nothing to worry about. But, you can have people come meet with you from a hospice and give you all the particulars, including their experience with your insurance, at ANY time. In fact, if there is more than one hospice in the area, you can "interview" them and decide well ahead of time that if the time comes, which hospice you would like to enroll in. While some hospices have a free standing in-patient building, and most hospices have designated beds these days in nursing homes or hospitals, most hospice care is at home as long as you have someone--or more than one someone--to be a caregiver at home, or you are well enough to handle most of your care yourself. You do not need to be home bound, let alone bed ridden to begin getting hospice care. Most people wait WAY to long to begin hospice care, and thus don't get all the benefits for themselves or their family members.
Here is a good website with lots of info that might be helpful. Local hospices may have their own websites as well.
http://www.nhpco.org/i4a/pages/Index.cfm?pageID=3254
thanks for all this feedback. It is a friend of mine who had this experience. She was using her husband's private medical coverage that had this 30 day limit - and has since applied for medicare .. thru ss disability.. as she is way too young for medicare ... and way too young to die. Sadly... the medicare probably won't kick in in time for her. It's good to know that others with private health care don't have this obstacle to deal with - we already have so much to contend with.
Hospice in CT is free if you have no other insurance to off set it. The people who work there are incredible and caring. They also provide counseling for the family during the care and after. When we had to make the choice for our mom, they made the decision easier and they worked with us to get her in a local nursing home so we could be close to her....
After reading your responses I think I should be a little more up front about what I've learned regarding hospice care so that each of you can better research this issue.
As with all medical care, there are a full range of hospice services, from inpatient hospital, nursing home, free standing and my preference, home care.
There is also a full range of funding from non-profit centers to for profit centers. In the U.S. for some reason we equate better care with for profit, but I have to tell you that from my research, the for-profit hospice
programs are troublesome, and there are reputable research ratings, similar to the national hospital rankings, that demonstrate this. As For-Profit indicates, these centers, no matter where the services are located, are in it for Profit.
In my research and limited experiences with Hospice, it is the Not or Non-profit Hospice centers that provide the best care, especially at home. They bill insurance and medicare/medicaid if they can, but I do believe they NEVER turn anyone away because of funding or
limit lengths of stays.
Please do research what Hospice programs are in your
area. I live in a community of 150,000 people and we have two non-profit hospice centers and numerous other private for profit, centers, three hospital hospice units and several assisted/nursing home options.
I have a friend who spent her last 5 days in a non-profit hospital hospice suite following a surgery for Pancreatic Cancer. We were able to be with her 24/7 and the focus was her comfort.
Another friend with stomach cancer spent his final two weeks in a stand alone hospice center because of special feeding tubes, ect. again having just gone through a surgical procedure. Both of these individuals preferred to go to home hospice care but because of extensive medical needs from their surgeries, weren't able to.
I know that when my father got over his fear of Hospice Home Care from a not for profit center after meeting with the Social Workers and learning that he was totally in control of what services he accepted and most importantly to him, that he would not be kept alive by heroic measures or suffer, he relaxed and for the most part enjoyed the remaining 30 days of his life
sharing that time with us rather than worrying.
I agree that we probably wait too long to explore this option and as some people have indicated, it does not necessarily mean or need to mean that we are at death's door; there are a lot of support services we probably have access to right now .... if we only know about them.
Seeing this discussion again, having recently spent a few weeks weaker than I've ever been and most importantly, now that my daughter and I are starting to have these discussions, I think I will be researching my local options now. I'll let you all know what I learn.
I have my hospice selected for when the time comes:
Visiting Nurse Association hospice.
PAMELA
I have been receiving Hospice care at home for six months. I'm told they will reevaluate every six months, but since I'm still dying, I will most likely be kept in hospice's wonderful care. If I got a lot better, it would be different, but I'm about the same as six months ago. It is the most loving, best care in the world, as they help me live out my final days. They find fun things for me to do, and they visit me a lot and it is like having a whole new group of best friends!
Chloemom,
I wish a lot of people who are against health care, that have their insurance and don't care about anyone else, would read your post. Insurance companies are for-profit, as one example, and have been taking much better care fo their bottom lines for he stock holders than any of the people that turn in claims. To hold the American public and government hostage to keep up their exhorbiant profits is disgusting!
Also, after reading more than 600 pages of HB3200, the original health care proposal, pages 424-426 explains the "lists" of people and associations that are available to patients and families that give us the information exactly as you describe is needed. No one seems to know what is available or from where and that bill would do just that. It is the passage that contains the infamous page 425 that the scare mongers claim contains the Death Panel! Isn't that an odd twist?
Chloemom,
Actually, I just went back and checked and the informtion on hospice and end of life information and care goes from 424-434.
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