Does anyone have any insights? Among many other things I am figuring out, I understand "getting better" is a criteria for coverage.
My mom is almost 92, being treated in a clinic bi-weekly plus VN at home over the past year for one deep ulcer. She had a stent put in, improved things a bit, but past two months not getting better, and wounds are now encircling her entire lower calf, skin is sloughing off, I see buckling on her upper calf. She can barely walk with the walker, but still does.
I asked Primary again if this qualifies for hospice now, and they wanted to know if she has fever or infection (No). So I guess they are awaiting some cruel event down the road. She's in a lot of pain now and obviously not getting better.
YOU can call the Hospice of your choice and ask for an evaluation.
If they want (and probably will) mom's medical records from her primary I am sure the description of the leg wound (if the doctor and VN have documented how serious it is) mom would probably qualify.
You can tell the person at Hospice that is taking your call that mom's doctor is resistant to referring to Hospice for some reason.
If you have a list of declines mom has had in the past several months let them know. things like...
She used to walk across her living room but no only walks 5 or 6 feet.
The wound used to be only the size of a quarter, it is now the size of a dinner plate and the Visiting Nurse does not seem to be able to manage it.
She used to not be in pain but the pain is now constant.
If they say that since her primary does not think that she is eligible for Hospice you might even suggest that a visit be made for Palliative Care. From your description I am sure as soon as someone sees it they may realize she would benefit from Hospice.
Mom was admitted into home hospice within about 24 hours.
Perhaps see a wound care specialist for a second opinion.
You might feel more confident that mom is getting the care she needs.
My question is, why has your Mom not been referred to a wound care nurse. Medicare provides in home care for things like this. Why does her doctor not write up an order for this? My daughter ran a Woundcare Unit in a hospital. The patients came to them for treatment. So there is a way for the appropriate person to care for this wound.
Hospice also treats pressure ulcers and provided wound care.
Just because someone is on Hospice doesn't mean wounds will get neglected.
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