Hospice-to-regular Medicare back-to-Hospice – can be complicated
Medicare will pay many (if not all) expenses of patients enrolled in hospice. But, patients cannot be receiving hospice services and continuing to receive treatment services from his/her previous medical team – consultation, yes; treatment, no. In early August we gave up on my being physically able to do the biopsy to determine if I had the genetic structure to try Lynparza. We joined hospice on August 11.
On August 26 the chief sent us a test kit for the new biopsy-free method might give us the same information. We quickly signed the paper to “de-enroll” from hospice (August 29) and took the test kit to the hospital lab for processing. We did not realize that it be nearly a month before our “de-enrollment” paperwork would clear through the Medicare system. We also kept three previously made consultation appointments with the “old” medical team. You can imagine how many Medicare claims were denied in the 6 weeks following – all of which needed
calls to various providers in order to get them paid.
Lesson: if you must de-enroll from hospice, presumably for a defined period of time, be careful the billing depts. at your treatment providers are well aware.
We were so happy when my sister Ginny called from Berkeley to say that she could come for a visit the weekend of October 23rd. Heidi and I enjoyed hearing about Ginny and husband Don’s trip to Portugal. She will return at Thanksgiving time to visit daughter and family. We are hoping to have another rendezvous then.
On a warm October 30th, we were visited by some spooks from Leesburg.
Happy Hallowe’en to all!
Love, Heidi and Bob
Local spooks – Lexi, Luke, and Kate
Ginny and Bob, September 24, 2016
Now that I’ve described some of my recent daily routine, I’d like to change subjects, to wit; how much longer should I expect to lie here in this hospital bed? I have felt increasingly tired all summer long, so tired I sometimes felt I might take my last breath at any minute. But, I very much wanted to see Kathy, Todd, Emily and Paula once again. Maybe those desires helped me stick with the program until the kids arrived. It was simply delightful for me they staggered their visits throughout those two weeks! At two&one-half Emily is as always tearing around exploring new things she picks up. Kathy’s visit was thankfully several days longer, and she was a great help to Heidi with the “patient.” Kathy had great fun videoing my reminiscing of Boy Scout and my Marine Corps days.
Kathy & Bob in mid-October 2016
My voice has grown much weaker. It takes energy to talk, in-person or on the telephone. We use a wheel chair to move me from my hospital bed to my recliner chair and back again. I have just enough arm strength to “help” move my body in and out of the wheel chair. An aide comes from Hospice twice a week to give me a sponge bath. The small dose of morphine, taken just before bedtime, keeps my stomach pain under control for 24 hours. But, the opioid interferes with my vision and causes constipation. My lack of appetite continues. Heidi does come up with things that do taste good once I start eating them. She is my angel.
Thursday, the 20th
Last night I slept peacefully in my new bed. I’m no longer interested in “why” this combination of medicines work, just delighted for the night’s sleep.
I slept in again to 9:30 Friday morning.
Stacy brought home crab for lunch from a local seafood shop. A cup of crab soup, a few bites of a fresh pear and two small bites of chocolate “wacky cake” made lunch today. I felt full afterwards. Todd, Paula, and Emily arrive late tonight from SoCal. Emily is now in the terrible-twos. We’ll see how much hub-bub she can create
Friday night I slept well again. Still dieting having hot tea oatmeal for breakfast. Saturday morning I slept in again. I could hear Miss Emily when I awoke. We enjoyed time with for the rest of the morning. Se loves playing with the big legos. I had broth, but pretty soon I found myself loosing my lunch. I took a Zolfran – anti-nausea and went back to bed.
Morphine can make one constipated. The array of laxatives I had been taking finally worked. I slept comfortably thru the rest of the night.
Todd, Paula,Emily and Bob – October3, 2016
Stacy and her family came down from Leesburg on Sunday. It was a good family day. Heidi made a video of Emily’s visit to feed the fish in the pond at the entrance to our neighborhood. Emily entertained us all singing and counting. We all enjoyed her before he went downstairs for her nap. Today Todd, Paula and Emily left for CA – Kathy lands at 9 pm.