Dementia is considered a major cause of dependency and disability among elderly people, and it can have a serious physical and psychological impact on patients as well as their families and caregivers.
According to the World Health Organization, around 50 million people around the world have dementia. It is a progressive illness that sees a patient’s cognitive function deteriorate beyond the degree that would be expected from normal aging, impacting their thinking, memory, judgment, and comprehension. There can also be a loss of social behavior, motivation, and emotional control.
Hospice care can help patients with advanced stages of dementia to live more comfortably, addressing issues such as pain and anxiety. It is known for its focus on allowing people to live out the last stage of their lives as comfortably as possible.
Hospice care’s holistic approach addresses the physical aspects of the disease as well as the spiritual and emotional elements of care and preparing for death. In addition to helping patients, hospice supports the entire family of those suffering from dementia.
When Should You Call Hospice For Dementia Patients?
Determining when to begin hospice care can be challenging for dementia patients as the disease does not follow a clear progression the way many other illnesses do.
Patients in end-stage dementia tend to require around-the-clock help with daily living. They lose awareness of their surroundings and recent experiences and have greater difficulty communicating.
To meet hospice eligibility criteria, hospice patients must have a life expectancy of six months or less if their disease follows its typical progression.
Although there is no set number of symptoms patients with dementia must show to be eligible, the following may be signs that it is time to consider hospice.
- Increasing hospitalizations and visits to the doctor or emergency room
- A diagnosis of pneumonia, sepsis, cancer, COPD, CHF or congenital heart disease alongside dementia
- Weight loss or dehydration that is connected to trouble eating and drinking
- Difficulty sitting upright or walking without assistance
- Trouble swallowing or frequently choking on foods or liquids
- Very limited speech
- Urinary and fecal incontinence
Eligibility For Hospice With Medicare
For patients to be admitted to hospice programs for dementia with Medicare, a scale known as the Reisberg Functional Assessment Staging Scale, or FAST, is used to assess the progression of their symptoms on 16 items.
Patients must have reached stage 7 on the scale to be eligible for hospice, which means they are unable to dress, use the bathroom, bathe or walk without help and have trouble speaking and expressing thoughts.
Hospice teams evaluate dementia patients and develop a plan of care, which is adapted as their symptoms and conditions change.
This plan is developed with the advice and consent of the individual’s doctors, and the hospice team works to coordinate communication so that all parties involved are on the same page. Their goal is to alleviate the physical and emotional distress that dementia patients often suffer and maximize their comfort.
Some of the factors addressed by the patient’s individualized care plan include pain, nutrition, skincare, agitation, feeding, hydration, and recurrent infection. Hospice also provides medical supplies, equipment, and medication-related to the patient’s diagnosis.
In addition, hospice provides emotional and spiritual assistance to patients as they navigate this complicated stage of life. This often includes volunteers to provide social support and conversation, chaplains for exploring religious and spiritual questions, and other therapies such as massage therapy or music therapy.
Hospice care is given to patients wherever they live, whether it is in their home, an assisted living community, or a long-term care facility.
What Can Hospice Do For The Families Of People With Dementia?
Caring for a loved one with dementia can be physically and emotionally draining. Caregivers may have to make decisions about their loved one’s healthcare and finances while still addressing their own work and family responsibilities.
Hospice care provides valuable support to families of dementia patients. They educate caregivers on how best to care for their loved ones and provide around-the-clock phone services so that help is always just a phone call away. Hospice teams can also help families make important treatment decisions that impact their loved ones.
When caregivers need a break, hospice may offer inpatient care. It also provides emotional and spiritual assistance to families.
Bereavement services are typically provided by hospice teams for up to a year after the death of a patient to help their surviving loved ones deal with their grief and express it productively.
Reach Out To The Caring Hospice Team
With dementia, your loved one’s condition can improve or decline often, and determining how long they have left to live can be difficult. At Harbor Light Hospice, our experienced staff can help you determine when is the right time to seek comfort care.