Alzheimer's Disease Support Group
Alzheimer's disease (AD) is the most common cause of dementia and characterized by progressive cognitive deterioration with declining activities of daily living and neuropsychiatric symptoms or behavioral changes. An early symptom is memory loss (amnesia), usually manifesting as minor forgetfulness that becomes pronounced with illness progression, with relative...
Rollie has been kicked out of hospice. Hospice called the VA to see if VA would pay for it, VA said, no way he has to be a Stage 7c. So Hospice said, 'sorry, but you are on your own again'
Basically he has to be on death's door, completely bedridden.
"In patients who remain alive, stage 7c lasts approximately 1 year, after which patients lose the ability not only to ambulate independently, but also to sit up independently (stage 7d), At this point in the evolution of AD, patients will fall over when seated unless there are arm rests to hold the patient up in the chair"
Notice how it says, 'in patients who remain alive...'
Hospice Admission Guidelines for Dementia --- Patient shows ALL of the following: (Patient is at or beyond stage 7C of the Functional Assessment Staging Scale {point 1 and 2 below}.) 1. Unable to ambulate without the assistance of another person. 2. Speech is limited to approximately six or fewer intelligible words (some hospices use the next requirement) 3. Unable to communicate meaningfully - speech is limited to a single understandable word on an average day - (or during the evaluation) (The single word may be repeated.) There is some variation on this point. Some hospices use 6 words as a limit. Some use a requirement similar to this -- No consistent meaningful/reality based verbal communication; stereotypical phrases or the ability to speak is limited to a few intelligible words. 4. Unable to dress or bathe without assistance 5. Urinary and fecal incontinence (intermittent or constant)
AND - Patient has had one of the following within the past year: (Demonstrates a declining condition and likely future medical urgencies.) Aspiration pneumonia Upper urinary tract infection (kidney involvement) Septicemia (blood infection) Recurrent fevers after treatment with antibiotics Multiple decubitus ulcers (bed sores) of stage 3 or 4 Poor nutrition demonstrated by 10% weight loss in six months or low blood levels of nutrients ( Serum Albumin less than 2.5 gm/dl) or difficulty swallowing food or food refusal Other significant medical event or condition that supports a limited prognosis (This additional point has been added by some hospices.)
Basically he has to be on death's door, completely bedridden.
"In patients who remain alive, stage 7c lasts approximately 1 year, after which patients lose the ability not only to ambulate independently, but also to sit up independently (stage 7d), At this point in the evolution of AD, patients will fall over when seated unless there are arm rests to hold the patient up in the chair"
Notice how it says, 'in patients who remain alive...'
Hospice Admission Guidelines for Dementia --- Patient shows ALL of the following: (Patient is at or beyond stage 7C of the Functional Assessment Staging Scale {point 1 and 2 below}.) 1. Unable to ambulate without the assistance of another person. 2. Speech is limited to approximately six or fewer intelligible words (some hospices use the next requirement) 3. Unable to communicate meaningfully - speech is limited to a single understandable word on an average day - (or during the evaluation) (The single word may be repeated.) There is some variation on this point. Some hospices use 6 words as a limit. Some use a requirement similar to this -- No consistent meaningful/reality based verbal communication; stereotypical phrases or the ability to speak is limited to a few intelligible words. 4. Unable to dress or bathe without assistance 5. Urinary and fecal incontinence (intermittent or constant)
AND - Patient has had one of the following within the past year: (Demonstrates a declining condition and likely future medical urgencies.) Aspiration pneumonia Upper urinary tract infection (kidney involvement) Septicemia (blood infection) Recurrent fevers after treatment with antibiotics Multiple decubitus ulcers (bed sores) of stage 3 or 4 Poor nutrition demonstrated by 10% weight loss in six months or low blood levels of nutrients ( Serum Albumin less than 2.5 gm/dl) or difficulty swallowing food or food refusal Other significant medical event or condition that supports a limited prognosis (This additional point has been added by some hospices.)
Whatever.................. here let me vent a little, I am from Canada but now a US citizen. In Canada Rollie would be in Hospice and there would be no question of me losing my home, I would have had more help a lot sooner, so YES, I do think we need a better health care system, one that isn't ruled by corporate insurance greed! Ok, stepping off soap box now.
So sorry....
This is the situation I have sort of faced, but Ron was never actually admitted,
but all the BS about the this and that letter of the law, without much kindness or compassion as it was being said...so, I think I KNOW some of what you are feeling...BUT, to have been accepted, then thrown out...shame on HOSPICE shame to do this to YOU.
Hospice should have checked with the VA before they told you yes, they did NOT do their job.. and certainly are not showing the kind of compassion one has thought was the very essence of Hospice.....
I too no longer count on Hospice. if we ever get it fine, if not, we will live or we will die, each/both of us but I will not count on these people.....
Ron is no longer walking as of last night but I remain convinced Hospice will find some other reason he is not eligible....
This is awful...If I had the energy I'd mount a revolution.....
hugs and love to you.....
Maybe I will get dumped too as it seemed to me Rollie and Rob are similar. Was it because you get a little help from the VA? It makes no sense. Do they not allow both? What ever it is it is wrong and I agree it was their error in the first place not yours. I am so sorry. Insurance seems to be running everything anymore. I have heard that Canada is a real good health system, ours definitely needs an overhaul. Greed ruins everything in every corporation and even in many people themselves.
You have a right to get on the soapbox!!!!!! This is just wrong.
I know hospice is a business - they must all have different rules.
I'm shocked... this seems a tad cruel.
If I were you I would become very aggressive getting SOMEONE to
step up and help you. Start with the VA... they owe Rollie.
at home hospice was paid by Medicare. One week a month of respite at their facility was also paid by Medicare. Ron's residential
3 week stay was paid by me at an affordable cost.
I think this is just shameful treatment.
Feel free to stay on your soapbox just as long as you like!Prayers for you that help will come soon, from somewhere.
In one of my former lives I was a QA person.....and one thing I know is that an Agency, any agency looking for payment for ANYTHING, has to know, be sure AND COMPLY with the rules for getting the payment....(I discovered for instance that one on my agency's program's was Medicaid funded but,,,,hard to even imagine....had FAILED to get the REQUIRED PCP signature and sign off form for admittance into the program.....this constituted Medicaid fraud or so much stupidity that the agency shouldn't have been allowed to operate a program...there is a very long further mess, but I won't go into that now..)
But, it was Hospice that was looking to get paid thru the VA if I read things correctly here so Hospice should have assured themselves, in writing, that the VA was agreeing to pay and the date of admittance(thus payment).....
Since Rollie is the VA client, the VA, having the slightest idea that Hospice was being considered, could have assured themselves that he was getting the best possible care by a simple phone call with the Hospice agency...something anyone with a paying job can find the time to do....
I am still incensed ("mad as hell and I'm not taking it anymore"), and more than ready to contribute some time, and a phone call, letter or email to anyone Deb might want .....just give a holler Deb if I can do something...you never know what a bunch of advocates can do, especially if they are pissed off Alz caregivers!!!! hugs....