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NoelUpstate Asked July 2022

Not sure what happens next as doctors recommended parent needs hospice?

Wow, a lot happening on the news from the doctors of my parent, who has dementia. They say he now needs hospice. Although we weren’t close, as sole sibling am I financially responsible? I understand from his girlfriend he has a small pension, savings and social security to cover these expenses. Would they take all of that and if so who covers the expenses of cremation or burial?

Taarna Jul 2022
Your parent's insurance should cover hospice expenses.

If your parent is short on funds and you are too, consider tissue donation. The local organization that does research (ask the hospital for contact info) would take the remains after death, harvest any tissues suitable for research, cremate the remains, and ship those remains back to you in 3-4 weeks.

If your parent is a veteran, some of the funeral costs may be reimbursed. Look at VA site online.

Lastly, look at low cost cremations locally to get an idea of cost.

Annabelle18 Jul 2022
When mother was placed on hospice, it was up to me to find a suitable facility for her. Even though she was on Medicare, had Premera supplementary, she/we were still responsible for paying the facility costs (I found an AFH for her). Just about everything else that pertains to "hospice" was paid for by Medicare. But check to see what the facility covers - at some places once you pay the monthly 'fee', everything is covered; other places, most everything is covered but not all. It all depends.

Just make sure, if your father is unable to sign for himself, that he is declared mentally or physically incapable of handling his affairs (which would activate the POA) and you/or other family member are his POA. And when you are signing the admission papers for her to enter a facility or hospital or whatever other papers you sign as POA, make sure you that you always sign your name followed by "as Power of Attorney for (your father's name)" - even though it might be cumbersome, but it covers your behind. That way you are showing that she is financially responsible and in no way are you responsible. If you sign just your name, you could end up owing $$ (but that is where the fine fine print comes in - you know, that clause on page 62 that says whoever signs is legally responsible.

As far as burial, it was the family's responsibility to pay for the burial/cremation. It all depends what the family wants and where you live. In the county I live in, cremation starts at about $1,500 plus the cost of the urn (which can vary from basic $150.00 to over $1,500). Burials here - without any services or anything else - just the burial - start at about $8,000 and go up depending on all what one wants, and doesn't include the plot which is extra - and once again, around where I live - it can be $10,000 and on up for just the plot.

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Grandma1954 Jul 2022
Hospice is covered by Medicare, Medicaid and most all other Insurance plans.
It, as far as I know is 100% covered. there may be "out of pocket expenses" if you chose to use an In Patient Unit or a Skilled Nursing facility rather than caring for for them at home.
You will get all the Supplies, Equipment that you will need to safely care for them.
A Nurse will come 1 time a week. A CNA will come at least 2 times a week for bath or shower, order supplies and bedding change if needed.
you will have the ability to ask for a Volunteer that can do a variety of things or just sit with your loved one.
A Social Worker and a Chaplain will be assigned as well. That is your "Team" that will help you.
Funeral services, whatever you want will be paid for by the "estate". If there are any funds now make the plans now and pre pay the service. It can be as simple or as elaborate as you wish.

ConnieCaretaker Jul 2022
"Would they take all of that and if so who covers the expenses of cremation or burial?" Not you!

KKathy Jul 2022
My experience with hospice is there is only a small bill to you and the rest is covered by the patients Medicare .when doctors say hospice they are sometimes saying nothing more medically they can do
TouchMatters Jul 2022
OOPS ! While it is your experience . . .
I would double check that Hospice sends 'a small bill' - it likely depends on the finances of the individual although my client had upwards of 1M and didn't pay anything for Hospice. And, it is NOT correct to say there is nothing more medically that can be done.
1. People do not need to be terminal to be in Hospice; and
2. A person may may 'graduate' out of Hospice depending on their health circumstances;
3. I believe a person is in Hospice for a year and then re-evaluated to determine if they continue in Hospice or not.

The inquirer of this post needs to check with hospice herself. And not rely on others' experience as there may be many variables to determine status / acceptance / costs. And, Hospice regulations may be different in counties or states - I do not know. Gena
ZippyZee Jul 2022
Send him to hospice, it's by for the kindest solution. It should be covered insurance-wise. Regarding final remains, donate the body to a medical school. They'll cremate them for free once they're done and send you the ashes.

Sample Jul 2022
Unfortunately care is decided by insurance companies. Hospice has been recommended for my wife several times but when you get past the obvious she is relatively healthy. Her family has a long life span. If she were to go on hospice ins only pays for 6 mos I think she will live longer perhaps a year. So I am waiting just pushing through care and life waiting to make that call. Too bad it is an insurance and financial question

DrLokvig Jul 2022
Call your state's Dept of Health AND Agency on Aging.

DrLokvig Jul 2022
Don't rely on this group for information. Too many kind people are misinformed AND the laws vary from state to state. Call your state's Dept of Health AND Agency on Aging.

DrLokvig Jul 2022
Hospice is covered by Medicare.

MAP2013 Jul 2022
The Hospice Social Worker covered all of this with the legal Power of Attorney. If married, that person is the spouse, not a child.

Children neither have financial obligations, nor rewards, unless expressly given to them by the parent.

Additionally, a child does not have automatic release of confidentiality for medical staff to share information on the patient's status.

The information seems to be coming to the writer from a 3rd party (a GF or spouse) because the writer is completely out of the picture. To be clear: hospice has not asked for payment (nor will they); conversely, the money from pension, savings or social security does not automatically go to the child.

Hospice is not the time to be wondering these questions. Consider if you want to go and hold their hand for their peace or yours. But, leave the questions of money at the door.

Llamalover47 Jul 2022
NoelUpstate: You do not foot the bill with your financials for any of your father's health care, including cremation/funeral.

FamilyNeeded Jul 2022
Be very careful about letting them put your father on Hospice. When my sister was put on it, I asked if she was dying and if so ...of what? They said she was not dying, but that they did so in order to provide more personal care. They told me you no longer have to be diagnosed with less than 6 months to live in order to get it.

But, there is a catch and you and your father's girlfriend need to know. They will DENY care, like an evaluation to see what's really wrong and to save his life especially if it is something simply done. In this case you must tell them 'TAKE HIM OFF OF HOSPICE'. Do not let him suffer or die needlessly. My sister had dementia and she did not deserve the horrible death they subscribed without telling family what was going on.

So, be careful! You are NOT responsible for the bills. But you can help in other ways. If they can not afford additional care for him. You can look into in home care. We have a program here in Wisconsin called IRIS. It is wonderful. It allows them to find who they want for his care (including family). They provide the funding for not only his care but things he would need in his home and even activities outside of the home. I believe all the states have similar programs for in home care. You could look into this for him or his girlfriend could.
Mark01 Jul 2022
With all due respect, I think you are confused about what hospice is.

Once you sign on to hospice, you are agreeing to forgo all curative care. Hospice may discontinue many of your medications, disallow blood draws and other diagnostic testing, disallow any procedures that may save your life. You need to enter hospice with eyes wide open, and fully understand what it is.

Hospice is about comfort, and only comfort. So, if you develop a UTI that is painful, hospice may allow antibiotics to be administered, but only because the antibiotics may relieve your pain. In general, hospice does not allow testing and treatments that may prolong your life, and hence, your suffering.

Palliative care, on the other hand, provides comfort care (like hospice), but also allows you to pursue curative treatments. So you get the best of both worlds. But hospice is a very narrow subset of palliative care, and has very strict requirements.

It's very important to know what hospice is, and what it is not.
my2cents Jul 2022
As his daughter, you're probably going to be involved in his care plan. Not financially obligated, but helping to process the paperwork to get him into a facility, Depending on total of income and what's in the savings, his facility care and expenses will be determined. Savings likely to be used up first to pay for his care, then his monthly income will pay each month. If income is too low, he will probably qualify for Medicaid to share the expense. So if he/girlfriend had been living together, it's very likely all his income will pay for his care now. G'friend will be short on income if they shared expenses.
Might be a good time to use some savings to pay for his cremation so you don't have to come up with the payment for that later on. Talk to social worker at hospital or facility where he is right now to start the process of paperwork for hospice care. If he plans to go home on hospice, figure out quick how many hrs of care he would have to pay for out of his pocket and how many Medicare/hospice will cover (they only pay for a brief visit - no regular shifts of care) and see if he can afford his care at home. May have to go to facility.

letitbe Jul 2022
Hello NoelUpstate,

The Social Security Administration pays about $255 for funeral, as to how long it takes to get that, as anything, case to case basis, however most all Beneficiaries are eligible. Hospice is free. Medicare/Medical pays fully for most paitents to recieve hospice/pallative care. Room and board in most "assisted living facilities" is what ia not entirely covered. Be sure to check in with all choices and make them clarify in writing what they present, charge and the plan they have in place to help Dad. Going through something similar. Prayers and Best wishes to your Father and you.
my2cents Jul 2022
The $255 is paid to a surviving spouse. So dad dies and mom gets $255 for his funeral. Mom dies and is still widow - no one gets $255 for her funeral. Crazy, right??
Caroscottage Jul 2022
Social Security pays about $150 and it takes months to receive.
KPWCSC Jul 2022
Unfortunately, only if there is a surviving spouse!

https://www.ssa.gov/benefits/survivors/ifyou.html

Do we pay death benefits? A one-time lump-sum death payment of $255 can be paid to the surviving spouse if they were living with the deceased. If living apart, they were receiving certain Social Security benefits on the deceased's record.

https://www.aarp.org/retirement/social-security/questions-answers/social-security-death-benefit.html
Patathome01 Jul 2022
As our readers have said, try to get VA to help as much as possible.

lealonnie1 Jul 2022
Your father's social security pension and savings should be plenty to cover the cost of his cremation, which is in the neighborhood of $1200 (or even less, depending on who you call and what you want). When my BIL died penniless, I believe my SIL got him cremated for around $750 and social services kicked in for part of that cost, too. As the others have already said, hospice is covered by Medicare. Your dad's girlfriend should know the amount of money he has in his accounts, and whether it's enough to cover his final cremation costs. Then you can scatter his ashes in a pretty place, as we did with my BIL; in the mountains, and we all said some nice words about him and some fond memories we shared of times we had spent with him. Your dad doesn't have to be buried, in other words, with a headstone and all the costs associated with such a thing.

My mother died in February of dementia and heart disease, and we're just now having her funeral service this Thursday (she was cremated). I'm sorry you are going through such a thing with your dad, and you have my condolences.

Best of luck with everything.

reallyfedup Jul 2022
Does your father have Medicare or a Medicare Advantage plan? If so, Medicare will pay for hospice. Here is a link with information: https://hospicefoundation.org/End-of-Life-Support-and-Resources/Coping-with-Terminal-Illness/Paying-for-Care

Burial/Cremation: Does your father have a will? Could he possibly have a pre-paid funeral plan? If he doesn't have a will at this point and his dementia is too advanced for him to make one, he will have died intestate. Any assets he has will go to his heirs. If his parents aren't living, then the assets will go to you as the sole heir.

If he dies intestate his estate will still have to go through probate and an executor will have to be named. This means that for the most part estate funds to pay burial/cremation costs will not be available immediately. I don't know anything about this problem, but you could check with the funeral home to see if there is a way to handle delayed payment.

Also check to see if your state, like mine, has what is called a small estate affidavit, which allows heirs to collect the decedent's property. If your father's estate is below a maximum value as established by state law and there is no real estate, you may be able to collect his property within 10 days. Check with the probate court in the country your dad lives in.

Beneficiary Accounts: If he has a durable financial power of attorney agent, that person can check to see if any of his accounts have beneficiaries named. If so, then that money does not go through probate and is available to the named beneficiary almost immediately after the account owner's death. Those funds can be used for burial/cremation if the beneficiary agrees. After his death, if you think you're a beneficiary of any of his accounts, bring a death certificate to the financial institution and ask if you have been named. If you have, you most likely will receive the assets right away.

Keep in mind that legitimate creditors, known creditors (such as hospitals) and taxes will have to be paid out of his estate, but you will not be responsible to pay them from your own funds unless you, for instance, co-signed to pay for something.

If for some reason in the end there is no money to bury or cremate him, check to see if your father's city or county has a burial assistance program. Also check with the county coroner's office. You may also donate his body to a medical school. Unless you sign an agreement to pay for it, you are not responsible for the cost of burial/cremation.

NOTE: Social Security: As far as I understand it, Social Security does not pay benefits for the month of death.

Suggestions. Not legal advice.

Mark01 Jul 2022
You are not legally responsible for the debts or expenses of another person. Period.

That even applies to a spouse. But since most spouses own things jointly (e.g. house, car, credit card, etc.), then a spouse would be liable for those specific accounts.

So, unless you signed your name as a cosigner of a loan, or as a joint owner of a credit card account, mortgage, etc., you are not responsible for your parent's debts or expenses.

Dizzerth Jul 2022
Hospice is covered through Medicare I believe. After hospice takes over there is no charge until the patient dies. Then you are responsible for burial or cremation and if you have a funeral, that expense as well. If they are a veteran that cost is covered.
lealonnie1 Jul 2022
My father was a WWII veteran on Aid & Attendance thru the VA and his funeral expenses were NOT covered. Neither were they for my mother, his wife, who received his A&A benefits as dad's surviving spouse after his death. The service and the plot/headstone was free, but dad paid for the cremations himself; is that what you are saying?
Erikka Jul 2022
If your dad was in the military, the military provides a free service and burial.

Lymie61 Jul 2022
Being your parents only living child doesn’t make you any more responsible financial or otherwise from a legal perspective than being his second or third child, oldest or youngest. You can get as involved as you want to with his care and death, Nothing legal requires you to and it sounds as though the smartest and best thing you can do for both of you is let the hospital social workers worry about and take care of those details. Many patients don’t have family to take care of these details for them and while they may not get someone picking places out or making sure the move and settling in goes well, they do get placed because that is the hospitals responsibility, making sure patients are released to a safe place with the proper care required. If he needs Hospice even better because they should find him a bed in a residential Hospice facility providing those exist where he is. How it’s all paid for isn’t your concern it’s the hospital release coordinator/social worker. You simply need to decide what you need or want for closure before Dad passes and take it from there, visits or not, deep talks or not.

NoelUpstate Jul 2022
Appreciate the responses. Advised, parents wife passed away while they were both in the hospital being treated for different medical issues. Due to level of dementia now father placed in short term Palliative Care, while they find a opening at a hospice, as both his kidney and heart functions have deteriorated, he cannot swallow, he’s not eating and continually agitated.

A lot going on at one time for me, since I’m his only living sibling…
Live247 Jul 2022
NoelUpstate, my encouragement to you as you go through this. You are where I was during COVID lockdowns which was terrible since I couldn't see my mom at all. Anyway, be assured hospice covers whatever care, supplies and medicines they deem necessary.
Primary question you need to answer for yourself is who has POA, you or the girlfriend? The POA document describes what authorities the POA now has or not. As POA, I will repeat what someone said, be sure you do NOT sign your name only - sign "Your Name, POA for John Smith."
Your parent's money will pay for his burial. You may use his money to prepay, arrange, etc. For my father, the VA buried him in the military cemetery with a very nice honoring way, engraved and placed a headstone, all for no fee. I thought this was always the case, but evidently others say not so, so be sure to check into your parent's VA benefits early so you don't duplicate and pay for something provided elsewhere.
Since hospice is now ordered, be sure to ask them for guidance for you, what you can expect from them, who to contact, what to expect your parent to experience and how you can help him and yourself.
My sympathies as you go through this. It was not long ago for me, too. Just know some days will be harder than other days, and when they are for me, I just let the day be what it is because I know tomorrow will be better/different. Peace.
JoAnn29 Jul 2022
Again, you are not responsible for any costs. His wife is. They need to track her down.

Hospice is usually done in the home but in Dads situation it will be done in a facility. As said, sign nothing. This is the wifes responsibility and her responsibility to hand over financial information. I would think that a judge can subpoena her to do so. Dad is entitled to his SS and pension to go towards his care and 50% of assets.

Let the SW do the job. You really have no way of knowing whats what in that marriage. (U said wife in first post and GF in next) Me, I would not get involved at this point. Let him become a ward of the state.

AlvaDeer Jul 2022
Hospice care is provided by Medicare after the patient is recommended by his doctor, and accepted by Hospice itself. Generally, if the patient survives the 6 month expectations, then the patient will be reassessed by both MD and hospice. Some patients have been on it for several years, though that is unusual.
Can you tell me what other illnesses or general signs of wasting or failure to thrive has led your parent's doctors to advise hospice? Do you feel you are well grounded in knowing what hospice is (end of life care)?
I advise you look online to educate yourself about Hospice, the mission, how it is paid for, what it includes, what the goal is.
Is your parent able to participate in his or her own care decisions at this time?
If so does the the parent wish to enter hospice?
Are you aware that Hospice means that there is no treatment now toward cure, and that few tests and no diagnostic procedures will be done? Are you aware of medication protocols that are aimed toward relief of any pain or agitation, even if those medications may mean death is hastened by some minutes, hours, days or weeks? Are you aware of all the support there is in hospice from social workers, clergy, grief counselors if needed?
Do a bit of research and it will help you form questions for Hospice interviews. I certainly do wish you the very best. I am sorry that you need hospice, but as a lifelong RN I thank goodness it exists. I wish you the best of luck.
Sharovd Jul 2022
AlvaDeer, what an informative answer! Thank you.
Ohwow323 Jul 2022
Sorry to hear --- but hospice is the best thing for you financially. The previous answers are great and I will not repeat them. I signed papers for hospice for my Mama, Daddy and Sister - not easy and I have learned with each one.
Prayers for you and your family.

Grandma1954 Jul 2022
You are not responsible for his expenses. DO NOT sign anything that will guarantee payment from you. If you are POA you can sign as POA. If you are not then unless you are his Guardian paperwork goes unsigned, print "patient unable to sign" or "Mr. XXX unable to sign".
Hospice is covered by Medicare, Medicaid and private insurance.
Pre pay funeral services now. Doing that you will also be less likely to be talked into something you don't want when you are more stressed. If he is a Veteran the VA will provide a headstone and plaque for the stone. It will not cover the burial. Social Security will also provide a (very) small amount. (But depending on when he dies they may also take back the last payment that is sent.)
With Hospice you/he will get all the supplies and equipment that are needed, a bed that hopefully will have an alternating pressure mattress that can help prevent pressure sores. A Nurse will see him weekly. A CNA will come and give bath, dress, order supplies at least 2 times a week, more if needed. A Volunteer can be requested so that the caregiver can get a break, or the volunteer can help do some chores just let the Hospice team know what help is needed. And Hospice also will cover about 1 week of Respite each year. (This is covered by Medicare/Medicaid, Insurance)
Hospice is one of the best decisions I made when caring for my Husband.
Now 1 more thing, if your dad is a Veteran the VA may be of help as well. Contact your local Veterans Assistance Commission and they can determine if he qualifies for help and if so how much. It could be a little or a LOT.
JoAnn29 Jul 2022
Concerning the VA. Not sure if stone and plot will be covered if not buried in a VA cemetery. There was something concerning this a while back where an OP was complaining the VA did nothing. Why? Because the father was buried in a regular cemetery.
MeDolly Jul 2022
You are not responsible for any of his expenses, none, don't even go there. Right now, Medicare should cover most of the expenses.

For future needs he may need Medicaid. Each state is different, call the Medicaid hotline and ask all the questions.

You do not need to claim his body, the county or state will bury him, as indignant.

Don't panic, there is help available.
Cover999 Jul 2022
Many will cremate
BarbBrooklyn Jul 2022
What expenses are you speaking of?

Hospice services (nurse, social worker, an Aide a few times a week, chaplain) are funded by Medicare.

Who is currently caring for your father's needs?

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