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My mother recently relocated to South Carolina. She suffers from congestive heart failure & CKD. She had a recent consultation w/her new nephrologist. Test results show that her kidney function has worsened. Her nephrologist recommended that she get hospice care to better manage her condition.


The thing is, my mom can still function — she cooks, dresses herself, and she’s alert mentally, though she has mild dementia. How would hospice work in this case?

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I would get a second opinion and a dietitian consult. My dad had the same ailments and the dietitian gave him great advice on eating and drinking, his kidney function improved pretty drastically.

She spent 2.5 hours with us and made sure that my dad understood how he needed to eat and drink to help himself feel better and not end up on dialysis.

I would be concerned that her new doctor doesn't want to deal with an elderly person and just gave her a death sentence because of his personal choice. Get a second opinion.
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KNance72 May 17, 2025
I find second opinions even Third Opinions count . Great advice . especially with the dietitian . Food is everything and you can heal from Illnesses with diet .
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Hospice is end of life comfort care when no further medical intervention is desired. No more doctor visits, no more hospitals, no life saving measures taken....just comfort medications are given to ease pain.
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From what you’re describing, it seems like palliative care might be a more appropriate option. It’s for people that have chronic or complicated medical issues that are not going to improve significantly, with goals to manage symptoms and reduce medical appointments. A practitioner will come to her home, usually monthly and can prescribe medications.
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I am of the firm belief that a person should have an evaluation for Hospice as soon as possible. The help, support that you get from Hospice is amazing.
Ask for a Hospice evaluation. If she does not meet the qualifications for Hospice she can receive Palliative Care and as she declines she will meet Hospice guidelines and the Palliative service can be transferred to Hospice service.

Hospice does not necessarily mean a person has "6 months or fewer" after the initial period a recertification is done if she still meets the Medicare guidelines for Hospice she will remain on Hospice. My Husband was on Hospice for almost 3 years. He continued to decline and continued to meet the guidelines at each recertification.
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To be honest, with someone who is functioning well on her own at this point, I cannot begin to imagine why hospice is suggested by this doctor.

Do ask doctor this question as regards this recommendation: "WHY?"
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Hospice would send a nurse once a week to start to check her vitals and such and would have aides to come help her bathe/shower about twice a week. You/she would have access to the hospice chaplain, social worker, and volunteers as well.
Hospice would supply any and all needed equipment, supplies and medications all covered 100% under your moms Medicare.
Other than that, they really don't do much, and 99% of your moms care will still be on you or other family members if she remains at home.
It can't hurt to bring them on board early as most people wait too late to bring hospice on board. Just don't expect much from them at this point.
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woe8myte May 13, 2025
Thank you.
I work/live in another state. I was able to set up home health/home care services for mom. My brother & I plan to discuss this with her-not sure if she’ll be receptive to it.
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I don't know the correct answer that works for you, but I can share my own experience with hospice.

So far, it has been a huge relief.

My parents started hospice two weeks ago, (92, both w dementia, plus my mom has chronic kidney disease, stage 4).

Because of hospice, my parents no longer have to be taken to drs appts. The RN case manager has come to their home at least twice a week. This alone has been a huge plus, because we no longer have to coordinate driving one parent to the doctor while another stays home. No more convincing my parents they need to go to the dr. No more getting my parents up and ready for their trip to the dr. Plus no more making drs appointments, period. No more dealing with drs offices, receptionists, messages not being delivered to the dr, etc.

A social worker visited. First she spoke to me to ask how I was doing. That has never happened with their former doctors. She asked me what my specific concerns were regarding my parents.

The RN removed medications that my parents were taking that were, at this point, no longer necessary. They have their medications ordered and delivered by hospice now. No more trips to the pharmacy or requesting meds from their drs and having to wait.

Hospice gives me access 24 hours a day if I have any questions or concerns. They give their assessment of how my parents are doing, instead of at the doctor's office, in front of my parents.

We have 24 hour caregivers, so hospice also guides the caregivers in their care, specific to each parent's situation.

Also, after 6 months, they are re-assessed, and either taken off hospice, or it is continued.

So for me and my specific situation, it has been very helpful.

I hope you find what works best for you.
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LinakaLou May 17, 2025
Are your 24-hour caregivers private pay?
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"hospice care to better manage her condition"

Hospice does not care for conditions. What does this doctor think they can do for kidney failure. Dyalisis would be the next thing I would think. When that is not an option and kidneys shut down, then its Hospice because you will pass. Hospice is end of life care. Extraordinary measures are stopped. Life giving medications are stopped.

Doesn't seem to me Mom is there yet. You could have a Hospice consultation to see if it is something Mom could use.
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Hospice, or palliative care, focuses on quality of life and not extending quantity of life. Her kidney doctor is letting you know that her kidneys are not working well and will not work well enough for her to have a long life. With palliative care/hospice, she can have health care that focuses on her being comfortable and able to enjoy the amount of life that she will have.
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Hospice does not "better manage care." Hospice is for end of life if you want access to strong pain meds like morphine. Once on morphine patients don't last long.
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Igloocar May 19, 2025
Morphine is usually offered in this country only near the end of life or om a very short-term basis. This is partly because of the legal issues currently associated with narcotics prescriptions, as well as the need for careful medication management, partly because of the possibility of physical dependence (NOT the same as addiction). It's not the morphine that causes the end of life, but the conditions that occasioned the morphine administration. Sometimes burn patients, for example, are on morphine for a very long time because of the severity of their pain.
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