Four Suggestions for Maintaining Your Exercise Schedule:

Choose exercises that you enjoy.
Pick a time that is best for you. (I need to exercise early in the morning or I just won’t get it done.)
It is better to exercise for 15-20 minutes 5 times a week, than 1-2 hours once a week.
Some people do better, if they have an exercise buddy.


Deciding When it is Time for Hospice.

The Medicare rules for hospice services require certification from 2 physicians to verify that the individual is expected to live 6 months or less, if the disease runs its natural course. Usually, the 2 physicians would include the individual’s primary care physician. This is the person that you would want to consult with first. The other physician can be the medical director of the hospice agency. 

It is expected that anyone who receives hospice services will no longer receive any life saving treatments, such as chemotherapy. The focus will then become the alleviation of physical, emotional, and social symptoms. Hospice can provide some valuable end-of-life services for patients and families.

The 6 month rule does not mean that if the individuals do not die in 6 months, they can no longer receive hospice. It just means that they need to be recertified by the hospice agency.

If one is not quite ready to make the decision for hospice services, it does not hurt to investigate obtaining palliative care services that focus on alleviation of symptoms experienced with diseases and their treatments. Receiving palliative care does not automatically disqualify one from continued life saving treatment.

My book, Healthcare Handbook For Senior Citizens and Their Families, provides more details about Hospice services and end-of-life care. See my website Also, you can find information about the hospice regulations on the Centers for Medicare and Medicaid Services CMS website (


Do Not Forget Home Health Care Can Be An Option.

If you or a loved one is being discharged from a hospital or care facility, be aware that if you run into problems caring for yourself after you get home, home health care is a good option. The doctor or nurse may ask you if you need a home health visit before you are discharged. At that time you may not see the need for a visit, but that does not mean that you can not change your mind after you get home. Also, do not assume that the doctor will automatically refer you, if you qualify. The doctor does not always know if your home situation would call for a home visit. Home Health agencies will make an evaluation visit to see if there is a skilled need and if your health insurance will cover the visits. Frequently, it only takes a few visits to help you adjust your care. My book, Healthcare Handbook for Senior Citizens and Their Families discusses the requirements for reimbursement for home care services.