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When we think of hospice care we often associate it with cancer patients, but it's valuable for patients at the end-of-life for other terminal conditions as well, including Alzheimer's disease. It would be a good idea to begin considering hospice if the patient is in an advanced stage of the illness. In advanced Alzheimer's disease the patient is unable to walk, dress or bathe without help; has trouble controlling urine and/or bowel functions; and only rarely speaks meaningful sentences.
More Specific Signs You Should Consider hospice care: According to Gregg Warshaw, MD, Director of Geriatric Medicine at the University of Cincinnati and Past President of the American Geriatric Society, if your loved one with advanced Alzheimer's is exhibiting any of the following symptoms, you may want to talk to your loved one's doctor about whether it's time to consider hospice care:
Two or more episodes of pneumonia or other serious infections during the past 6-months
Difficulty eating and swallowing, even with feeding help, that results in weight loss of 10% or more over the preceding 6 months
One or more skin pressure ulcers that are not healing
10 Most Common Questions about Hospice Care:
What is hospice care? Hospice care is a team-oriented, compassionate approach to care for terminally ill patients that focuses on improving the quality of life and reducing pain and discomfort. It strives to help patients live their final days to the fullest, with dignity and support. Hospice care addresses physical, social, emotional and spiritual aspects of the patient's life.
Where are services provided? In patients' homes, assisted living facilities, nursing homes, free-standing hospice facilities or hospital hospice units.
How does my loved one qualify for hospice care? The patient's physician must certify that the patient is expected to live less than six months if the current illness runs its normal course. The patient must also have either Medicare Part A or qualify for services under Medicaid or Tricare, a military service member and family benefit. Some private insurance companies also pay for the care.
What services are provided to the patient? Primarily physician and nursing services; physical, occupational and speech therapy; medical social services; home health aide and homemaker services; counseling; short-term inpatient care; prescription drugs; and medical appliances and supplies.
What services are provided for family members? Primarily respite care and bereavement counseling. The latter is provided before and up to one year after the patient's death.
Who pays for it? Medicare, Medicaid (in most states), some private insurance companies and Tricare. In all cases, coverage applies only to issues related the terminal illness - not to room and board in any facility or other medical conditions that may arise during the time the patient is receiving hospice care.
How long can my loved one stay on hospice care? Two periods of 90 days each or an unlimited number of 60-day periods.
Can we stop hospice care if we change our minds? Yes, you can stop at any time for any reason. You can also reinstate hospice care later if you wish.
How can I locate a reputable hospice care agency? You can get referrals from family members or friends; a hospital social worker, discharge planner, or care manager; your physician; or local nursing homes. There are also many excellent directories, including the one at www.hospicedirectory.org.
Where can I get more information? The Hospice Foundation of America ( www.hospicefoundation.org ) is an excellent source of information. You can also Google the following organizations to find their Web sites: Centers for Medicare and Medicaid Services and National Hospice and Palliative Care Organization. Both have a wealth of helpful information.
Although starting hospice care for a loved one can be a somber and painful experience, just remember it will help both you and your loved one have the highest possible quality of life during the precious time that is left.
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