Someone on the advanced prostate cancer online support group ask about what are the criteria to go into hospice care. One individual replied that you would need to be within 6 months of your potential death.
Another person replied from their individual experience. They said, “Hospice in CT doesn’t have a life expectancy strictly attached to it. What I learned since my mother in law is currently in at home hospice is:
The patient’s primary care doctor has to sign off that the patient will not improve. So in effect the condition is considered terminal.
The first sign off is 3 months, then in another 3 months. This is where the 6 months may come in, but this doesn’t mean the person has to die within 6 months. There is no time limit although they do reassess. Once in hospice care you can opt out of it again and then re-enter it.
It is completely covered by medicare. Their main focus is to provide comfort care. The intervention to go beyond in trying to cure the cause no longer becomes important. I believe this is why they can provide this service, because it then becomes something where Medicare then saves money in the long run.
We chose at home hospice for my mother-in- law. Immediately a hospital bed was brought in, her oxygen was converted over to a company they use. Morphine and anti anxiety meds were prescribed- even generic advil to name a few things.
A nurse comes in minimum of 2 times a week for up to 2 hours each time. An aide is proved to start maybe 2 times a week for 2 hours and both can be increased as needed. The aides are allowed to be companions, do a little cooking, shopping and washing clothes for the patient. The amount of time a nurse or aide comes becomes dependent on the needs of the patient.
About the morphine- We were very wary using it. My mother-in-law is having trouble breathing and taking oxygen. We gave her ½ half of the smallest dose. That day her breathing improved. Apparently, what they say is the morphine in small doses is help her capillaries to open to receive the oxygen. She is on very small doses.
If there is a problem Hospice asks we call them first. This week my mother in law had a situation where she had a temp of 103 and shaking. How they handled it they have a team of nurses, aides and one doctor assigned to the patient’s case. Your own private doc is and can be involved. They immediately sent a nurse who stayed with her for 2 days around the clock. To keep her out of the hospital they will stay until she is stable.
There are many more people involved like a massage therapist, a singing guitar player – and so on. She has a case-worker assigned to her case.
The main point is the person has to be terminal and a doc has to sign off on this. If a person continues to live beyond 6 months or a year – is not a condition of hospice. You can at any time get off hospice and back on your own plan to begin working on treatments if a person does begin to improve, or one chooses to
The family’s wishes are abided by. We believe we did the right thing. We chose Hospice at a perfect time. We needed help badly. Going back and forth to the hospital wasn’t going to work. Trying to call our doc wasn’t going to work. We now have a team of people who are supporting us in many ways beyond what we thought we could have.
Now, in saying all of this my mother in law has been in hospice at home now for about 3 months. We are new at it.
Our guess is that she will be in hospice short of 1 year. We don’t expect her to live past next spring. She is 93.
I hope this helps; it’s just one person’s experience.
The advanced prostate cancer support group is full of dynamic, generous, experienced people who unselfishly share their own personal experiences and feelings. If you think you might be interested in joining us (requirements are you must have advanced prostate cancer or be a caretaker) go to:
www.groups.yahoo.com and search for the advancedprostatecancer
Joel T Nowak, M.A., M.S.W.