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My wife is bed ridden and now has stopped eating. She is getting very weak she drinks water but not enough.


She is 79 and also has MS. She says it hurts every time she is moved. She has substantially declined in the last 3 weeks but refuses to go to the ER.

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It is time to have this discussion with her MD. Usually an MD attests to the fact his expectation is that end of life is approaching and will be here within the next 6 months. At the end of 6 months the patient will be reassessed by MD and Hospice if end of life remains near for further coverage by Medicare. It must be understood by patient and family that death is near, there must be an opting out of further treatment toward cure, further testing toward diagnosis, and etc. Comfort care treatment is still given no matter what the cause of the discomfort, and is in fact the priority. There will be support of nursing, aids, clergy if wished, social workers.
This is a discussion for you and your wife to have with the doctor. Then arrangements can be made for Hospice interviews and evaluations.
I am so sorry for all your wife is going through and I wish you both the best.
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I was only going to add that it does not have to be your own doctor to order hospice. It can be the hospice doctor if her doctor will not make the referral.

But, Barb said that already.
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MJ1929 May 2022
ER doc will order it.
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https://hospicefoundation.org/End-of-Life-Support-and-Resources/Coping-with-Terminal-Illness/How-to-Access-Care

The above is a link to a fact sheet put out by the Hospice Foundation of America.

It specifically notes that the patient or family can contact a hospice organization directly if they have difficulty getting a referral from their own doctor.
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Hospice requires a doctor's order to perform an evaluation. Patients accepted in hospice, must suffer from a terminal disease which is no longer responding to treatment, or if a patient with a sound mind refuses to continue treatment. Once accepted, no treatment for the terminal disease is provided. Only medicines to make the patient comfortable and pain free.
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MargaretMcKen May 2022
There's not much treatment for MS, so I doubt if stopping any treatment is a problem.
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Sample, does your wife have a regular doctor you can consult about whether a hospice referral would be appropriate?

If not, call the local Area Agency on Aging and ask to be referred to a mobile doctor, or a telemed vist.

Or call a local hospice provider (non profits are preferred by most of us here) and ask for the best way to b proceed.
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Sample May 2022
Yes talked to the doc today and going to the er for evaluation
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