Hospice nurse indicated Mom may not be re-certified. What do I do?

I haven't posted in a while...

My Mom (94 yo) is still having good days and bad. Though, her good days tend to be more challenging for me since she doesn't sit still and won't/can't listen (more of the same). She is incontinent (both bowel and bladder), but still goes into the bathroom out of habit. She continues to need assistance walking. She is eating three meals per day (though refused to eat dinner tonight), but the quantity is less. She does pocket some of her food. The only thing I noticed that was unusual for her was that over the past week, is that she started drinking more than usual. It is almost as if she would rather drink than eat. (Still chokes on water.)

One problem is that my middle brother -- the only able-bodied sibling that was able to help me care for Mom -- had a medical emergency last week. He hasn't been fully diagnosed yet, but it appears to be heart arrhythmia. He had an episode when he was near his basement steps and ended up falling down them. Fortunately, he only suffered from major hematomas (no broken bones). But, he can't help me with Mom any longer, or at least until the doctors figure out what is going on and the necessary treatment. (He has to wear a heart monitor for a month.) He used to at least stay with Mom during the day on Saturdays so that I could have a break.

My younger brother has the same heart problem now.

My sister, though she was not able to help due to her MS, broke her leg the other day. She is not home from the hospital yet, but I will not be able to help her because of being with Mom. I have only been able to feed her cat the past 2 days.

My older brother (the one who lives with Mom) has been saying that he doesn't expect to be around in September. (Does he know it is almost September???) But, he said that last year, too. He seems to be having good days, too. Although, his oncologist said the leukemia drug stopped working and that he didn't like the looks of the bone marrow test. He is still waiting for more test results. It has been over two weeks now....

I was feeling upset and resentful this past weekend because my son asked me to come to dinner, but I did not have anyone to stay with Mom. This week, I did hire a CNA to come to Mom's from 4:30 until 6:30, four days per week now so that I can leave Mom's early. I am hoping that will alleviate some of the stress. That doesn't mean this caregiver will be available for spur-of-the-moment things, though (or even other times besides what she was hired for. She does have other patients.). For those moments I relied on my middle brother. I can't do that now.

But, the other wrench in the stew came from the hospice nurse today. Mom has to be re-certified for hospice every 2 months now. The nurse was indicating that Mom does not appear to be showing a decline, therefore, she may not be re-certified. (I guess it is from all the good care I have given her -- keeping her safe from falling....) But, Mom was doing well (relatively speaking) when the nurse was there today; and Mom vitals have always been good. When the nurse practitioner came a few weeks ago, Mom was in bed. That nurse felt like Mom would be re-certified. But, from what I heard today, the decision is made by a team. I will know in 3 weeks.

So, if Mom is not certified, I told my older brother (the one who lives with Mom) that we are probably going to have to put her in a nursing home because we will lose the hospital bed, wheelchair, etc., and the support that I have (and I cannot continue to do what I do). (Yes, we can buy/rent our own equipment if we have the money....) But, that doesn't change the amount of time I would have to put in for the all over care. At least now, I get some help from hospice with bathing. It will be too costly to have private-pay caregivers for a long time (not knowing how long Mom will live).