CAREGIVING: Recertification is one of those things that I am glad I can worry about it. Kathy is doing well enough that she needs to be recertified to continue with hospice care. Medicare pays for hospice, but the general rule of thumb is that since it is end of life, comfort care it is restricted. In other words they want to make sure you are close to kicking the bucket. It is a little more complicated with Huntington’s Disease since ‘end stage’ isn’t predictable as a time frame.
Kathy is really doing fine, considering everything. She manages to squeeze out an occasional word or two each day. She seems to really smile and appreciate everything we are doing for her. And I believe she is relatively happy. She is really enjoying having a little chocolate ice cream every few days.
When Sharon, the hospice nurse called to let me know they were reviewing Kathy’s case, she said she would be coming over with a nurse practitioner (NP) to recertify her. Sharon arrived first to get all the vital signs etc. She said the NP “will want to know what areas Kathy has declined in.”
I said, “Well…. I can’t really think of anything.”
“Well… we have to say something.”
“But it seems like she is really doing better with the hospice care, doesn’t it?”
Sharon reminded me that I had to turn the feeding rate back down because she was regurgitating it. “That is one thing.”
Then I started to get it. But it was more like we were putting a bad face on something.
“Well… she seems more rigid in her limbs”
“And… she can’t speak or communicate.”
“And… her eye is still full of dried crud.”
“And… she had some infections.”
“That’s probably enough for now.” Sharon said.
When the NP came Sharon filled her in. Kathy seemed sound asleep, which was probably good. All of her important vital signs were good: Oxygen, blood pressure lung sounds. The NP said everything looks good for another 60 days. As they left they said goodbye to us and Kathy said “Okay.” Clear as a bell.