Okay...I really don't know how to ask these questions

so most of this is going to be jumbled so please bear with me.

My father has Stage 4 cancer and is reaching the end of his life. He has actually survived longer then the doctors had originally thought he would. He is currently in a nursing home which he went to after a month's stay in the hospital. Since getting to the nursing home, his infections have cleared up and he has regained mobility. He can complete all the activities of daily living. Because of this, his need to be in a nursing home is nil. In addition, he would like to return to his home of 40 years to pass away.

I'm fine with all that. Here is the problem, of all the children, we all work and have very small children. He lives an hour away from me and I am not in a position to help very much during the week. Neither are my siblings. So, if he goes home, how is he checked in on? He can't speak so the phone use is limited. Also, when the end does come, what happens? Does hospice come to him or he to it? Who do you call to come to the house and get him if he passes there? I just don't know.

Any help would be appreciated.

Re: Okay...I really don't know how to ask these questions

It's possible for him to get in home health aides.

These people will make sure he is taken care of. You can check on him several times a day and speak to the aides and the social worker/agency that supplies the support.

Another option may be for him to come stay with one of his kids (you or someone else) and get an aide for during the day while you are working. You can also get a visiting nurse who will get his vitals and make sure his meds are right. This way you can be sure he is ok.

Before he is discharged from the nursing home you can arrange all of this with referrals to agencies for help.

I'm so very sorry your dad is so sick.

Re: Okay...I really don't know how to ask these questions

First off, I'm so very sorry. It's so hard when a loved one is sick.

When you arrange things with Hospice, they will come to him and the healthcare workers/social workers should be available for him as often as needed. If you have arrangement made ahead of time (we did this for my Mom), you will just need to call the place where the arrangements were made and they will come and get him. Also, if your Dad is a religious person, you can also arrange for someone from his church to come and visit or give Last Rights when the times comes. I'm not sure how it works with other religions as I can only speak from the point of view of the Catholic Church since that is what my Mom was.

Again, I am so very sorry.

Re: Okay...I really don't know how to ask these questions

Unfortunately, I know a bit about this topic. With regard to what insurance will cover, it will depend on whether he has Medicare or Medicare and a supplementary policy.

Medicare alone, has something called a hospice election. To be eligible to make a hospice election, his physician must certify that he has less than six months to live (this isn't hard and fast and people can live in excess of six months, but the reasonable medical expectation has to be six months or less).

The benefit of a hospice election is that all durable medical equipment is covered, all medication and supplies are covered and you get more nursing coverage, and home health aide coverage, typically, up to 5 hours a day, anything more you will have to look to your secondary payer for or pay out of pocket.

In addition, hospice is straight palliative care and you are not eligible if you are seeking actual treatment like chemo, dialysis, etc.

If you are not in a situation where a hospice election is appropriate yet, things might be a bit more difficult, because Medicare only provides you with help in the form of a home health aide, if you have a skilled need (meaning you require the servcies of a skilled nurse) and it doesn't sound like that's your situation right now.

I would speak with the social worker at the Rehab facility and also ask Visiting Nurse to come and assess his needs.

Good luck!!! As I said, I only understand to well what your family is going through.

Re: Okay...I really don't know how to ask these questions

Thank you all for your responses. It really helps.

He was sent to the nursing home as a form of palliative care but the Medicare portion is running out as his 100 days are almost up. Medicaid is in process but that can take up to 3 months. Luckily, he overcame a blood infection that they thought would take his life.

He wants to go home; not to any of our homes. I"m glad to here that in home hospice is still an option. I was recently told that it may not be an option since they have hospice houses now.

Thank you.

Re: Okay...I really don't know how to ask these questions

Re: Okay...I really don't know how to ask these questions

Visiting nurse association, or in home hospice care.

Or, you have to pay for 24/7 help.

Im so sorry you are in this position and I send prayers your way!

Re: Okay...I really don't know how to ask these questions

My mom had hospice at home for 1-2 weeks (didn't work out so we eventually moved her to a center). They provided an aide for 5 hours a day M-F and a nurse visit once a week. We used Good Shepherd Hospice. HTH!



I am so sorry this is happening.

Message edited 3/17/2010 9:08:04 PM.