Medicare and Hospice

• By pattyf
• Posted September 7, 2007 at 6:39 am

I don't have an experience of being denied, but just the opposite. My Mom was in the final stages of bulbar onset, and was probably in a pre-coma state when she developed what the hospice nurse thought was probably a UTI (urinary tract infection). I chose to give my Mom antibiotics and she was given Cipro. Antibiotics are not 'extreme' messures, but simply provide comfort for the patient.

I would question the hospice and if they still don't cooperate, I'd change! My guess is that they're thinking of the almight bottom line!

God Bless you and your wife!

Patty

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• By msgar1ginny
• Posted September 7, 2007 at 11:13 am

Cale joined our local Hospice after he was trached. We had been home 4 days when he made the choice to go into hospice. At the time he used the vent only at night or when he thought he needed it. We had been on hospice less than a week whrn he developed pneumonia. I was asked if he wanted to go to the hospital, stay home or try intravenousantibiotics at home. The Hospice director had to approve the antibiotics. They were approved that day and Cale was given Fourtaz for ten days at home. Our hospice thought of it as comfort.

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• By KimHymes
• Posted September 7, 2007 at 1:07 pm

Hi Rickliu, Thank you for sharing the difficulties you are having with your local hospice in Wyoming. I would be happy to provide you with resources that can address the questions you raise. Please feel free to contact me in the Advocacy Department of The ALS Association at khymes@alsa-national.org. Please know, we are always available as a source of information for a variety of issues including Medicare, Social Security and other Federal programs. I hope to hear from you.

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• By clary925
• Posted September 8, 2007 at 10:52 am

rickliu,

Apparently, from having read quite a number of similar posts on Living with ALS, there can be fairly wide differences between hospices. I recall another case exactly like your wife's, antibiotics for pneumonia was being refused. Others around the country replied that they had just the opposite experience, much like that posted by the other commenters and antibiotics were considered comfort meds. If Kim is able to find a resolution for your case, it may be very helpful if the solution or solutions are posted here for all the rest of us who may run up against a similar situation.

God bless you, your wife and enlighten the hospice.

Clary925

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• By KimHymes
• Posted September 11, 2007 at 1:39 pm

Hi Clary925,

Thanks for your example, which correctly points out that hospice policies do vary across the country. Because of this variance, privacy laws and our desire to provide accurate information, the best course of action for anyone experiencing similar difficulties is to contact the ALS Association Advocacy Department by emailing khymes@alsa-national.org . We are always available as a resource on a variety of Federal programs that impact PALS and their families.

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• By maypema
• Posted November 11, 2007 at 8:25 pm

Hi,
The choice to receive antibiotics in case of pneumonia is not one which should have caused a denial of hospice benefits. I would obtain a written note from the hospice stating exactly why receiving antibiotics caused the denial of benefits. They should be able to give you the exact policy which shows why they dropped benefits.
Hopefully you will find a hospice which can offer you and your wife the support you need.
Maya Ananda

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