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If she gets discharged from hospice, she will still need a hospital bed.
Does Medicare cover this? Does hospice take their items back? I hope we can use the service as long as we can and she is approved. She can't walk-we sit up on side bed and we clean her-


She is bed ridden from a fall (shoulder break) but had many set backs now won't walk- healthy before this. She just had a decline in health so hospital referred us to hospice care- Aide comes 3 times a week, RN comes twice- RN stated they will probably drop visits to once a week. Vitals good. Just bed ridden. Failure to Thrive is the DX- A fear from a fall will damage an eldery person very fast. We hope to keep her home as long as we can- we Tried a NH for rehab and the service or lack of service there almost killed her. So we made a complaint on them with the State. Once it gets too much does the social worker with hospice help her get placed in NH- how long did your loved ones stay on hospice. She does feed herself, we just can't move her or take her out to doctors appt. we only give vitamins daily disconntued BP meds etc -


I do think she will live past 6 months but we do need the help from hospice

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Your grandmother may not be discharged from hospice; she will be re-evaluated by the hospice. If she is improving she could get discharged and your grandmother most likely would have to take over the rental of the hospital bed; but check with medicare regarding DME. If you have any questions speak to the hospice nurse about your concerns. My father's hospice team were wonderful and the nurse in charge of dad's care was always willing to answer any questions the family had.
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Imho, hospice rents their equipment.
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Most in-home Hospice' go each 6 months with doctors note (I just called my primary doc, he gave ok- even without seeing him), up to 4x (2 years), some maybe longer...Medicare picks costs: medicines, diapers, bed pads, equipment (beds, table, oxygen if needed, creams)-they take equipment back when not needed. (They even gave us a hoist and wheelchair with pads, but it took me 5 hours to get him to porch, so didn't use it again.) All I paid for is the baby monitor and his Boost/Ensure Plus drinks. My husband fell, became quadreplegic after spinal fusion. Our hospice sent aide every day to bathe/clean him...nurse 2x a week for BP, temp, medicines, and catheter check. They only wanted to give 3x a week, but I complained that I can't clean him alone. (I had to help aide also). Ended up getting steady, regular aide 5 weekdays, and 2 aides for weekends (subs). He had spent 8 months in hospitals/NHs (3 months of which was no visitation), and because of COVID, couldn't get the physical therapy needed, and wanted to die at home. We spent the last 4 months together, and also had his 77th Zoom b'day party, which was a blessing. I had kept family/friends informed on his condition throughout, so about 50 of them (out of 86) came. Hung cards on wall unit around TV, so he can see them, and made sure that whomever called, spoke with him. Played his favorite TV shows, talked, made his food he enjoyed (while he still ate). Make sure you get a fully electric bed, helps when changing/cleaning. God bless you and your Grandmother (she's lucky to have you to care for her well-being).
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tboudreaux1982 Mar 2021
yes right now shes getting nurse twice a week, aid three times a week- she is dead afraid of falling and after so much time in bed, she cant even stand up but she is a sweetheart - she is so upset over all this- we will do it as long as we can, she has a great support team i just hope they stick around to help me-- right now she has some swelling in her feet
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Call the hospice office and ask. It's possible they take their equipment back, but could arrange with doctor to order a bed via Medicare and have everything swapped at same time. They probably also have access to social worker who can assist you with moves to NH, etc. Start with them
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Not all Hospice agencies rent their equipment from DME suppliers. Some of the larger ones own the equipment and loan it to patients. If the patient is removed from hospice, the bed will go back.
However, Medicare 2will pay rental on hospital beds. If after 13 months of full Medicare rental, you should own the bed. However if the patient is on a Medicare Advantage plan, some companies negotiate a lower rental than what full Medicare pays and it will be returned to the supplier no matter how long the bed is rented.

My wife came off of hospice over 2 years ago, by my choice, but is still qualified to be on hospice, in fact after her last hospitalization 2 weeks ago, they recommended hospice again. , I just choose not to use them.

ie They will treat a UTI but will not culture it. My wife has chronic EBSI UTIs (EBSI; Escherichia coli bloodstream infection) which must be cultured or you're just pumping antibiotics into her for nothing.
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tboudreaux1982 Mar 2021
good info- my grandmother is the same way with UTI's
we did have her cultured while in hospital but like you said im sure they dont with hospice
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I'm not an expert in this but I suspect the Medical supplier that Hospice uses is more than willing to help you get Medicare to pay for this bed as well as any other equipment you need. I don't think hospice will leave you high and dry without a bed but will give you time to get the transition of another bed. Medicare will pay for bed, and a commode I think... but it's considered "rented" until it's been paid for or until you've had it for a set amount of time. They have different rules for oxygen equipment than they do for beds for some reason. And, I'm not sure what the rule is about wheel chairs but I know power chairs aren't paid for. I'd talk to Hospice because they probably have a social worker that can help you out with questions like this
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I was a Hospice nurse for years.
ypu have a lot of questions- talk with your nurse and SW. they can give you answers that relate specifically to your loved one.
there are some really good answers here, some not so much.
Basically- talk to your team about your needs.
Failure to thrive has very defined criteria for continuing hospice care.
we celebrate those who get better and come off Hospice care, but do not leave them without a good plan for continuing care at their improved level of need.
Bless you for your caring heart. And talk to your team. 😉
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tboudreaux1982 Mar 2021
THANKS
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My father started hospice in MC two weeks before covid lockdowns. We pulled him out after 8 weeks of total lockdown. Hospice stayed with him at his apt. where he had 24/7 caregivers. They reevaluate every so often. I’ve heard of some individuals on hospice for a couple years! They’ll help with necessary meds, briefs, ointments, first aid supplies (my dad fell and had skin tears). Upon passing they’ll take their equipment back, but not before unless you drop Hospice for some reason. Great program and wonderful people!
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If she is discharged from hospice, they take back any durable equipment that you are not renting or have bought. Talk with social worker about the need for a hospital bed - and any other equipment - if she is discharged from hospice. Most people are not discharged from hospice if the reasons for hospice continue to be an issue. The fact that her usual medications have been discontinued seems to indicate that hospice will provide comfort measures and that she is expected to pass.
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No.
Everything is returned and reused for the next hospice patient. My mum was on hospice for 2 years up until she died. Recertification is done every 6 month. When mom died, the hospital equipment people took everything--the oxygen, bed, table, wheelchair, feeding pump, bed..it all went back.

IF you mum does not meet criteria and gets discharged from hospice, your doctor can write an order for medical equipment including hospital bed and Medicare will pay for it, but that too gets returned once she dies. That however takes time, and has a LOT of paperwork. Very FEW things Medicare will pay for which you can keep; namely, a walker and bedside commode and sometimes with a co-payment. If there was evidence of skin breakdown Medicare will pay for a specialty cushion--but the doctor will have to document it.
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When my husband was in hospice care they told me stories of some patients being in hospice care for 6 years. I wouldn't worry about being taken off of hospice care.
But again insurance dictakes what care is to be given also how long care is given. Insurance plays god but God has the last word.

Good luck Remember all is in God's hands. He has full control.
Prayers going up for you.
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As others have said, hospice will reevaluate regularly about keeping your grandmother on hospice care. My mom was reevaluated several times before she passed.
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The bed is from Hospice it is a rented bed and it will be picked up the day or day after they are discharged.
Begin NOW documenting ALL the things that could indicate a decline.
Increased sleeping.
Not being able to do or do as well any of the ADL's or things she did previously.
Increased agitation
Not having the same level of interest she did previously
Increased incidents of choking
Having to thicken liquids more
Having to puree foods
Eating fewer meals or less at each meal.
Could walk 20 steps 2 weeks ago can only walk 10 now. (this would be for others not your mom, the suggestion to document is for anyone)
Any little thing no matter how insignificant it seems can help keep her on Hospice.
Dropping visits does not necessarily mean they will discharge her from Hospice.
If you wish the Social Worker can try to get her placed in a facility. You could also ask, if this happens that she be transferred to Palliative Care. Often the same staff is assigned and they will let you know when they think she would be eligible again for Hospice.
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tboudreaux1982 Mar 2021
I sure will keep track of everything
thanks so much
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If the Dr put her on Hospice, she will stay on Hospice. You can stay on Hospice even over a year.
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Waterspirit Mar 2021
There has to be ongoing documentation of deterioration. Yes, a person can be on for over a year or more. However, if someone begins to improve, they can be discharged. We used to rejoice when a patient was well enough to come off of Hospice but we always reassured them that should their condition change we would be back in a jiffy.
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You aren't required to die within six months to stay on hospice care. Talk to the hospice company's social worker and they'll explain how it works.

If she is taken off hospice care, though, yes, the bed would go. I changed hospice companies when my dad was sick because the first one was so awful, and the bed and equipment for Hospice #1 was picked up and replaced by Hospice #2 in the span of about 45 minutes. The two companies coordinated the timing to keep my dad as comfortable as possible. (He just went to his old room for an hour and rested on that bed.)

If you do have to rent another bed for Grandma, I'm sure you'd be able to get the two companies to similarly coordinate the timing to keep her from being disturbed too much.
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tboudreaux1982 Mar 2021
thanks for info
I spoke with the social worker
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If Hospice supplied the bed it will be picked up by the same medical supply company that set it up. The equipment that Hospice supplies is rented.
If you had the bed prior to hospice it would be yours to do with as you wish.
As long as there is a documented decline she can remain on Hospice. (My Husband was on Hospice for almost 3 years)
Most Hospice do have a Hospice Unit for In Patient stays for symptom or pain management. Or for respite. If they have a room. While on Hospice Medicare will pay for about 1 week of respite per year.
If it gets to the point where you can not care for her the Hospice Social Worker will do what they can to find a bed in an appropriate facility. It is generally easier for Hospice to place someone as the facility that accepts the patient is probably under the assumption that the person will not be a resident for an extended time
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tboudreaux1982 Mar 2021
thanks for info
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Many churches have lending closets for DME, durable medical equipment.

I would make some phone calls and see if you can get one that way. I think that the rentals are not cheap.

I pray that whatever care your grandma requires is given, meaning hospice stays involved.
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Hospice does not own the equipment that is needed for the client. They have a provider. If Hospice is no longer needed, yes the provider will expect their equipment back. When my Dad died, the provider was there the next day to pick up the bed and equipment. Can u make a deal with the provider to rent the bed, maybe? They may be able to set it up that Medicare continues covering the rent.
Medicare does cover hospital beds. They actually pay to rent them. I was made to understand once the renting covers the cost of the bed, then the bed is paid for and you can keep it. Before that time, the bed has to be returned to the provider. We dealt with this where I worked when people donated beds. We had to make sure they owned them outright.

Hospice probably will not help you get her back into an NH unless they have a SW. I don't think either of our local Hospice agencies have SWs. Mom was in a NH at the time and I got no call from either the NH SW or anyone from Hospice other than a nurse about her care.

If your Mom has been diagnosed with a failure to thrive, unless she does a 180, I don't see where Hospice would discharge her. They just don't see the need for the xtra visits. The Nurse should be available by phone 24/7.
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tboudreaux1982 Mar 2021
Thanks!!!!
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Ask the hospice. but I think that the answer is that the bed will go; it is a rental. But speak with hospice. They may have good advice for you.
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It's been almost 2 decades since Medicare provided a hospital bed for my father, and since I haven't kept up on those regulations, they may have changed.  At that time though, Medicare considered ownership of the hospital bed to transition to him.    It was then his to keep.

He wasn't on hospice though; he was recovering from severe complications on multiple levels.

I would research the Medicare site under "DME, hospital beds", to see what you can find.
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Hospice will keep caring for your grandmother as long as she continues to qualify for their care. They do evaluations every 3- 6 months. My husband was under hospice care in our home for the last 22 months of his life. He was completely bedridden as well.
Now if for some reason they decide that she no longer qualifies for their care, you will probably have to start paying rent for her hospital bed, and of course have to pay for all her supplies, and medications as well. That is one nice thing about being on hospice as all that is covered 100% under you grandmother's Medicare, and one less worry for you. But remember too, that if this hospice agency decides she no longer qualifies for their care, you can always check with another hospice agency in your area to see if they will take her. Often times they will.
And yes the hospice social worker will help find a nursing facility if needed for your grandmother, and if needed too, she can be placed in the hospice facility as she gets closer to dying.
I wish you the very best, and God bless you for taking good care of your grandmother.
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tboudreaux1982 Mar 2021
i would like to keep in touch with you- being you have gone thru this
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