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I was reading through some comments on the various topics here (so many very helpful questions) and wanted to ask: is hospice supposed to provide a daily helper to the family? We have not had the best experience with hospice for my FIL and they told us he needed extra help but never offered it through their organization.
A nurse came out once a week (missed one week because she said she had patients in more need) and they sent a volunteer a couple of times a week to give him a bath.
We were told that medicare would not pay for visiting nurses AND hospice and then essentially told that hospice is brought in so the patient can get painkillers. We have never been offered any kind of additional help and was told we needed to find help ourselves.

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Here in Mass. they connected us with an aid, but we had to pay for it.
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In Minnesota we had the hospice nurse coming twice a week, a social worker every couple of weeks, and a chaplain was available. We could have also had a volunteer come in for a few hours a week. Medicaid was already providing 32 hours a week for a personal care attendant and I declined the volunteer, feeling other families needed it worse than we did.

The program was explained to me, and I was not expecting daily help from the hospice program.
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Here in Texas, my MIL is in a nursing home. She was placed on hospice a week ago. A case manager nurse visits her once a week. A social worker visited and will check back monthly. A chaplain will come once a month, unless she wants to see the chaplain in the meantime (chaplain is optional) An aide visits the nursing home 3 times a week and does whatever is needed.
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From what I understand, we could have chosen a different hospice service organization. We went with the same one that took care of my FIL last year. Perhaps that is the variable? The organizations themselves?
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My understanding (after helping 3 people go into 3 different hospice programs) is that the specific hospice program determines their offerings. My most recent experience, was the patient was given 2 hrs of aide service 5 days a week; a nurse once a week initially and then more often as needed; a social worker and spiritual director bi-weekly. If you are in an area that has more than one hospice service available it is important to interview them to see what they offer. One of my other hospice experiences offered volunteers to come and read or sit with those who needed company. This was an important benefit for my 58 year old friend to help pass the time. If you aren't happy with the service, investigate alternatives.
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I imagine that most hospice programs provide what Medicare will pay for. Beyond that they use volunteers (or what they can support through donations). It is probably easier to recruit volunteers in some areas than in others.

As geewiz says, understand the benefits offered by the program you are considering.
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