Life Support Issues/father


My father stopped eating a little over two weeks ago.  We talked to him and gave him the choice of staying at home or going to the hospital.  He says he is tired of doctors and wants to die at home.  He is not on hospice.  We tried to get the VA to let us have it, but the doctor said he doesn't qualify because he is not ill with cancer or anything.  He is just blind, unable to walk and in poor health.  Are we doing the right thing by letting him decide?  It is so hard to watch him get thinner and thinner.  I want what is best for him.

The VA doctor is incorrect.Only 1/2 of hospice patients have cancer. Many patients have what is called failure to thrive and they meet hospice criteria. If your father has lost 10% of his body weight in 6- months (and it sounds like he has) he  probably qualifies for hospice care. Yes indeed, you are doing the right thing in allowing him to decide. Moreover there is probably not any other treatments that will make him live longer although the hospice will tell you about them if there are. There is a lot that can be done to make him comfortable at home. Sometimes hospice even helps patients to improve and gain weight once they are comfortable and less depressed. Under Medicare and Tricare hospice pays for a lot of extra's such as medical supplies, medications and medical equipment.   

Your father has a right to pursue hospice care both under Medicare and Tricare. It is the hospice themselves who evaluate him for hospice care. If the hospice is incorrect in taking him , there are penalties. My point is that the VA doctor is not the person who evaluates him for hospice. If he honestly believes that hospice is only for cancer patients, he is out of touch.  

This is how it works if he is at home. You all call the hospice and ask for an evaluation of his condition to determine if he is eligible for hospice care. They send out a nurse who evaluates him and the the hospice calls the VA doctor to let him know that your father meets the qualifications.

If for some reason he does not qualify, many hospices have a palliative care program to serve patients who are not eligible for hospice. The palliative care program sends a doctor out to evaluate his comfort level. This is also covered by Medicare.    

The important point is that help is available and it will benefit both your father and your entire family.  

Life Support Issues

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Betsy Murphy


My expertise is in end of life care for adults. Identifying when someone is approaching the end of their life. Benefits and burdens of end of life treatments. Managing pain and other symptoms. Providing care for dying patients at home. Advocating for someone who is dying in a hospital or nursing home.


More than 28 years of experience in hospice care. Currently consulting with hospices to promote access for patients to receive hospice care earlier in the course of their illness. Betsy provides training for hospice marketing staff to effectively work with nursing facilities to help identify eligible patients. She writes Additional Development Request (ADR) letters to Medicare to help hospices get paid for their services and to avoid future claim denials.

Hospice and Palliative Nurses Association

Articles: Clinical Reviews, Advance for Nurses, Nursing Spectrum, Washington Business Woman,; Understanding Medical-Surgical Nursing (FA Davis and Company), Guide to Caregiving in the Final Months of Life (TM Brown publishers).

Bachelors of Science in Nursing, additionally trained as a Family Nurse Practitioner and certified as a hospice and palliative care nurse.

Awards and Honors
Outstanding Woman in Loudoun County (VA) by Loudoun County Commission on Women 1997 and 2002.

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