We just switched hospice providers for 91 yr old Mom. She has been on hospice for 9 months and they said she was doing great at every weekly visit. I never understood why they kept recertifying her and didn’t receive any clarification. So I switched as I felt it was financially motivated.
She is currently being reevaluated by the new hospice provider but she had been doing so well that I began the process of moving her from my home to AL.
She has COPD but has no shortness of breath and 92% O2, left atrial stenosis and short term memory glitches. I have noticed ever so slight changes in her—sleeping about 14 hrs a night but now some naps during the day, a slight decrease in food intake (but her appetite and consumption are still very good)—but the visiting nurse said she had a lot of muscle wasting despite the good nutrition she’s had over the past 9 months. She has only lost 2lbs since then. She has been staying in bed about 23 hrs a day since moving here 9 months ago even though she could leave her room if she wanted to. Her BP has been falling and she’s on an antidepressant.
Is this the wrong time to be moving Mom based on her current condition?????
Medicare will not allow recertification without the documentation of decline.
Each of the things that you have indicated is reason to recertify.
Decrease in eating
Muscle loss. This is not the same as weight loss although they can go together.
Sleeping more
One of these alone would be reason to recertify
How does mom feel about moving from your home to AL?
She can be on Hospice in either place.
In AL she would have staff that can help her. BUT if she is in bed for as long as you say I doubt that she would get repositioned as often as she should be to prevent pressure sores. So I would think a move to a Skilled Nursing facility would be a better option or even Memory Care where there is more direct contact with the staff that would be available to reposition and change her at least every 2 hours.
From all you say, your Mom certainly mentally can manage this, but physically she would be the highest level of care at level 4, and if she is basically bedbound you need to make that clear as many facilities will not accept a senior who cannot leave the room for communal meals, nor WILL leave it. If I recall other posts from you you described Mom as basically wishing to remain in her own room, overall. She may require a higher level of care than that available through ALF. Memory care, if she has really very little memory loss would likely not be a good fit due to her being with a roommate more than likely, and with people who have poor mental acuity.
I would speak with your Mom's MD and with your Mom herself and would also visit a few facilities in your area. You have a clear vision of your Mom, her abilities, her needs. She may be a better fit for a family run Board and Care where she has her own room and there are few residents.
Good luck in trying to think all this out the best way you can, and I hope you find the best "fit" possible.