Caring for patients with dementia can be challenging.
Hospice services specifically designed to assist families and caretakers of patients with Alzheimer’s disease or other forms of dementia can help with the challenges faced in taking care of their loved ones, both physically and emotionally.
At Three Oaks Hospice, the focus is on care, dignity, and comfort. We offer services tailored to the individual patient’s needs. For patients with end-stage dementia, hospice care can include symptom management, pain relief, and a focus on maintaining quality of life during those final weeks or months.
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When To Call Hospice Care for Patients With Alzheimer’s Disease or Dementia
Alzheimer’s disease and other forms of dementia tend to develop gradually over time. Knowing when to contact a hospice provider about starting care for the end stages of dementia helps patients, families, and healthcare providers plan.
A neurologist or personal physician may recommend hospice care for a dementia patient, or the family can ask the patient’s doctor for a referral.
Hospice Eligibility Criteria for Dementia Patients
While the typical requirement for hospice care is a life expectancy of six months or less, this is sometimes difficult to ascertain for dementia patients. Cognitive decline can occur unexpectedly, so a person with dementia symptoms that impact their quality of life may become eligible for palliative or hospice care even if the total life expectancy with dementia remains uncertain. Patients with dementia may be eligible for hospice care if they can no longer do any of the following:
- Control bodily functions, including bladder and bowel functions
- Walk or move around without assistance
- Bathe themselves
- Get dressed without assistance
- Speak or communicate effectively, which in the case of dementia means being unable to use more than six intelligible words a day
Dementia patients with specific comorbid conditions may also be eligible for end-of-life care. Some conditions that may contribute to a life expectancy of 6 months or less for a dementia patient include:
- Congestive heart disease
- Strokes
- Renal insufficiency
- Liver disease
- Cancer
Dementia patients who’ve had one of these related secondary conditions within the past 12 months are also eligible for hospice:
- Septicemia
- Recurrent infections, including upper respiratory infections, pyelonephritis, and pneumonia
- Multiple stage 3 to 4 decubitus ulcers
- Recurrent fever after taking antibiotics
- Impaired nutritional status, defined as weight loss of 10% or more, a BMI of less than 22, or a serum albumin level under 3.1
How Hospice Helps Family Members Care for a Dementia Patient
End-of-life care can be stressful for caregivers, and hospice helps relieve this stress by taking care of necessary tasks so family members can spend time with their loved one. Hospice can also help families better understand dementia symptoms, so they know what to expect as dementia progresses through various stages.
Some specific benefits for family caregivers provided by hospice include:
Respite Care
Family caregivers often become overwhelmed when assisting a patient with dementia. The hospice team can offer temporary hospice care for dementia patients while the family caregiver takes a break. Respite care can be provided for up to five days, and Three Oaks Hospice can provide transportation if needed.
24-Hour Access to Care
Three Oaks Hospice can provide caregiver support 24 hours a day, 7 days a week. From on-call support when caregivers have questions to dispatching nurses for immediate assistance any time of day or night, help is available for daily tasks and unexpected issues.
Bereavement Support
Bereavement support is available for caregivers from the beginning of hospice care and after the patient’s death. Three Oaks Hospice offers bereavement counseling for up to 13 months after the patient’s death.
Advance Care Planning
Sometimes caregivers are uncertain about navigating insurance, medical paperwork, or funeral arrangements. The social worker assigned to a dementia patient can help the family with paperwork and logistic concerns such as filling out paperwork, navigating the hospice conversation with family members, and providing assistance with funeral arrangements.
How the Three Oaks Hospice Team Can Help Patients and their Families With Dementia
Hospice patients with dementia require individualized care since disease progression can vary from person to person. The hospice team works in conjunction with the patient’s regular health care provider to develop a flexible care plan to account for day-to-day changes in the patient’s condition.
Late-stage dementia patients can often not make their needs known, so they rely on hospice staff and caregivers to remain aware of potential issues and ongoing needs. Some things covered by a comprehensive hospice dementia care plan include:
- Pain and symptom control
- Infection prevention, wound care, and skincare
- Emotional support
- Spiritual assistance
Our hospice team is made up of a variety of professionals and volunteers. A team manager coordinates care. Some members of a hospice team include:
- Nurses
- Social workers
- Volunteers
- Clergy members
The hospice coordinates the acquisition and maintenance of medical equipment, medication, and medical supplies for patients with specific medical care needs.
Three Oaks Hospice Locations
Three Oaks Hospice has locations across the U.S., ensuring that caring, compassionate hospice and palliative care are available to patients where they live. Three Oak Hospice provides on-site care in the home or where the patient calls home, whether that’s in their residence, a family member’s, or in a medical facility.
Where Hospice for Dementia Takes Place
We can provide hospice care where the patient lives, such as in the patient’s own home, a family member’s home, a long-term care facility, or an assisted living community. Additionally, we can provide hospice care for dementia while at a hospital during temporary inpatient stays.
Hospice providers visit the patient regularly in coordination with the family. Patients who need specialized services may require more frequent visits, while those with fewer immediate medical needs might receive a visit from a hospice professional every few days.
Talking to Family Members About Hospice for Advanced Dementia
Deciding when to begin hospice care can be challenging for many families. As a patient approaches the end of life, dementia symptoms often worsen, so addressing the need for hospice care in advance can make things easier when the time comes. Some things to consider when discussing the possibility of hospice include:
What Hospice Involves
Patients and family members may be confused about exactly what hospice entails. Hospice isn’t a specific place, and it doesn’t mean the person is giving up on life. Instead, hospice is a way to navigate the end-of-life process and ensure a high quality of life.
The Patient’s Specific Wishes
When someone is in the early stages of dementia, they may still be able to express their wishes for end-of-life care. Having a conversation about what a parent or loved one wants out of hospice and dementia care can help families make tough decisions later. For some patients, remaining in the home as long as possible may be the goal, while others might be worried about becoming a burden on caregivers.
What Timeline Might Work Best for Considering Hospice
Discussing hospice criteria for dementia and the typical progression of Alzheimer’s and related dementias makes it easier to create a timeline for when the patient should enter hospice.
The Benefits of Hospice for Alzheimer’s and Other Dementias
Hospice benefits patients and their loved ones beyond the immediate support of symptom management and pain relief. Some reasons patients and their families choose to receive hospice care include:
- Receiving hospice or palliative care in a familiar setting helps patients remain comfortable
- Hospice teams can help with activities of daily living, including personal care and household tasks, freeing up loved ones to spend quality time with the patient.
- Hospice patients tend to have reduced hospitalization rates because they are monitored for potential medical issues.
- Patients and their families feel more secure because services are available 24/7
- Emotional and spiritual assistance helps patients and families prepare for the end of life.
- Often allows the patient to remain in a familiar environment
