Hospice Criteria for Dementia.
More than 5 million Americans are currently living with Alzheimer’s disease and related dementias and more than 15 million family caregivers are providing unpaid support to their loved ones with Alzheimer’s or other dementia.
In the early stage of Alzheimer’s disease, individuals will experience memory lapses such as misplacing objects or having trouble coming up with the right word or name. They are still able to function independently, but will have increasing trouble with planning and organization.
As the individual reaches the moderate/middle stage, they will begin to require more care. It is during this time that the individual begins to experience more severe memory loss and confusion. They may be unable to remember names or be confused about where they are. Some individuals in this stage may need help remembering to dress appropriately for the weather. There will be changes in sleep patterns and personality. This stage typically lasts the longest – often for several years.
In end-stage dementia, individuals will require 24-hour assistance with daily living. They lose awareness of recent experiences and their surroundings and have increased difficulty communicating. Individuals with late-stage Alzheimer’s become vulnerable to infections, especially pneumonia. During end-stage dementia, it is important for caregivers to anticipate their loved one’s needs as they may even forget how to suck from a straw or how to swallow.
Due to the slow progression seen in individuals with Alzheimer’s disease and other dementias, families are often times unsure when their loved one becomes eligible for hospice by meeting established criteria for dementia. There is no specific number of symptoms a patient must exhibit to be eligible for hospice care. Please review list of commonly seen symptoms to determine if your loved one is exhibiting any of these symptoms and determine next steps.
Hospice eligibility criteria for dementia:
In order for a dementia patient to meet the hospice eligibility criteria, he or she must have a life expectancy of six months or less if the disease continues in its typical progression. For patients with dementia, it may be time to consider hospice when the patient’s physical condition begins to decline. Some key things to look for include:
- a diagnosis of other conditions as COPD, CHF, cancer or congenital heart disease
- an increase in hospitalizations, frequent visits to the doctor and/or trips to the ER
- a diagnosis or pneumonia or sepsis
- weight loss or dehydration due to challenges in eating/drinking
- speech limited to six words or less per day
- difficult swallowing or choking on liquids or food
- urinary and fecal incontinence
- Unable to sit upright without arm rests on chairs or may slip out of chairs and require sitting in special chairs
- unable to walk without assistance such as a walker or now requiring a wheelchair
- unable to sit up without assistance (will slump over if not supported)
- no longer able to smile
Dementia symptom management.
Crossroads Hospice & Palliative Care creates an individual interdisciplinary plan of care to meet the unique needs of each patient. For patients living with Alzheimer’s disease or other dementia, our team provides medical care to alleviate symptoms including pain and anxiety and personal care to assist caregivers in maintaining the patient’s dignity at end-of-life.
Medication related to the patient’s primary diagnosis and medical supplies such as incontinence products, hospital beds and wheelchairs are included in the hospice benefit, typically at no charge to the patient or family. These items will be delivered as needed to the patient, eliminating the need to run to the pharmacy or to research medical supply providers.
In addition, our team of emotional and spiritual support specialists provide education and support to family caregivers. This includes volunteers to sit with the patient so family members can take a break without worrying about the patient’s safety and assistance in arranging respite care. Our staff can also assist families with end-of-life planning, making funeral arrangements and bereavement support.
For the dementia patients that meet the hospice criteria and are already receiving care in a memory care unit or other long-term-care facility, Crossroads Hospice & Palliative Care is available to partner with the facility to provide an extra layer of one-on-one care and attention. This includes providing complementary therapies and activities to supplement the clinical and personal care the patient receives such as reading or playing music for the patient, foot massages, or aromatherapy.
Our goal is to provide an enhanced quality of life for patients with end-stage Alzheimer’s disease or other dementias, making the most of lucid moments and ensuring the patient is comfortable and free of pain even when they are no longer able to communicate their needs.
For primary care physicians.
Crossroads Hospice & Palliative Care is your partner in providing support to patients with late-stage Alzheimer’s disease or other dementias. We are available 24 hours a day, 7 days a week, 365 days a year to admit new patients. Our care team will work with you to facilitate an easy transition to hospice care for the patient and their family.
If the dementia patient doesn’t meet the eligibility criteria or is not yet ready for hospice, the support of palliative care in the home may be appropriate. Our palliative care team works side-by-side with physicians to treat symptoms and side effects, alleviate pain, and address family questions and concerns. Our team provides regular reports to the primary care physician, providing you with an extra set of well-trained eyes and ears in the patient’s home environment and alerting you to any changes in the patient’s condition.
When to call hospice.
Due to the slow progression of Alzheimer’s disease and other dementia, it can be difficult for family members to determine when a patient becomes eligible for hospice care. Starting the hospice conversation early means you will have time to get all your questions answered and put a plan in place before a crisis occurs.
Crossroads Hospice & Palliative Care is available to assess the patient in their home environment to determine whether they meet the criteria to begin hospice care. This assessment can take place in the home, a long-term-care facility, nursing home or hospital. We are happy to meet with families at the time and place most convenient for them to further discuss the hospice criteria for dementia.
To arrange a hospice consultation, fill out the form on this page or contact us via the blue Help Center Bar above. Our team is available 24 hours a day to take your call.