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Can anyone tell me something about the " approval " process for getting hospice

involved in care? About eight months ago my mother's cardiologist and

neurologist referred her to hospice due to uncontrollable swings in blood

pressure, and hospice came to evaluate, but felt that she was not within their

12 month life expectancy parameter for inclusion at that time. The process of

evaluation was very stressful for all of us, and although I don't think Mom was

fully aware of the implications, she doesn't like strangers in her space, asking

her questions, asking her to move about, etc. Since that time hospice has been

in touch to find out how things are going and they feel that re-evaluation would

be appropriate now. However, it was difficult enough to go through the first

time that I want to delay until I feel relatively certain that my mother is

declining rapidly and irreversibly. She still has very good days where she can

walk and talks lucidly interspersed amongst the days that she can't walk at all

and only mutters or is uncommunicative. At this point she needs a full time

caregiver to help her do everything, so the hospice care would be a big

financial help, but when I ask her neurologist about this she punts and says she

doesn't know much about the hospice process. I was surprised by some of the

questions that hospice asked over the phone to evaluate her condition.

Incontinence of the bowel was one (she is occasionally, but not always), weight

loss, and the ability to sit unassisted on the side of the bed. This last I

found very surprising as we hadn't focused on her falling backwards when left

sitting for any length of time. Does anyone know what this is a sign of? The

hospice rep also said that given Mom's various diagnoses (Lewy's Bodies, MSA,

Parkinson's Plus) that they might find that she is declining more rapidly and

thus could be covered earlier than another patient showing similar symptoms that

has only been diagnosed with Alzheimers, for instance. Can anyone give me any

feedback on all of this?

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