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My mother plays in her food or throws it on the floor. The nurses feed her and she will eat all her food. She is wheel chair only so when would be a good time to sign her up for hospice? With dementia Alzheimer's it's just a steady decline in her abilities.

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Gloria, Being in a wheel chair or not eating are not signals for hospice. The stage of the disease is the factor. The general description for hospice services here is 'failure to thrive'. One thing that would indicate that: Loss of weight. The staff will continue to feed her. Playing with her food is an action associated with Dementia. It doesn't necessarily mean she is nearing the end of life. Pocketing her food (keeping it in her mouth, back in her cheeks) is more of a signal of getting near the end. Hospice services are generally happy to come and evaluate. Your Mom's M.D. writes a script for an evaluation. If your Mom is on Medicare, they pay for hospice services. Generally, the initial period is 3 months with a reevaluation of need at that time. People now come on and off hospice services as needed. I know someone who has been on for 19 months now. And another person that was on and off 4 times in the 11 months prior to her passing. If you'd like the evaluation done, let the MD or hospice say your Mom isn't ready. Hospice can make her feel more comfortable and give her more company. But the natural course of events will prevail. Good luck.
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When the doctor gives her 6 months or less to live.
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My mother's geriatrician just told me that Medicare has new rules for eligibility for hospice care for dementia. It is now much tougher to get hospice care. I would say to talk to her doctor about it. Sign up when she becomes eligible.

With dementia it is very difficult to estimate remaining life expectancy. In many types of cancer or other diseases it is possible to say "when this happens, and this test result is X and this test result in Y, then it is highly likely the patient will die within the next 6 months." There simply aren't similar standards for dementia. I understand that Medicare needed to come up with some guidelines. What I heard was ridiculous, but that aside, I think getting hospice help as soon as a patient qualifies for it is valuable.
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Ask the social worker. Also ask what costs are. God Bless you this is difficult to watch.
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Dementia aside, lack of mobility makes people susceptible to other maladies, as does overall aging. Even if the dementia does not qualify her, she may eventually develop something easier to "measure" like heart disease. Have her evaluated, if she does not meet hospice, ask the doctors again when you see further decline, they have seen it before, are the professionals and frankly are more detached.

I favor hospice as a compassionate end of life stage.

Good luck
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Many elderly people in or out of wheelchairs stop feeding themselves and no one would stop offering them food. As long as it is accepted and does not cause vomiting and she is able to swallow. Dementia in itself is not an indication to involve hospice and Medicare rules make it increasingly difficult to qualify. As long as mom is being well cared for there will be little benefit to her .If she has something else such as kidney failure, cancer or heart failure and you wish to stop something like chemo or dialysis that is another issue . from what you have told us it is not yet time. By all means have hospice come in and evaluate and they can give you a better idea of when they would be able to admit her.
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