Family caregivers sometimes don't link hospice with dementia. Hospice often is viewed as something to ease physical pain for a patient with an end-of-life illness such as cancer.
However, pain also can be mental, stemming from dementia in all of its forms, including Alzheimer's
Disease. The pain affects not only the patient, but also the caregiving family. A loved one with dementia who is diagnosed with less than six months to live may qualify for hospice care, according to the Hospice Foundation of America. This includes financial insurance support for hospice costs from Medicare, Medicaid and many private plans.
Dementia Has Many Forms
Caregivers should keep in mind that dementia is a term not only for memory loss, but also for a group of symptoms that arise from brain diseases. In fact, memory loss alone will not qualify patients for hospice care. Evidence also must exist that patients no longer can think well enough to perform daily activities such as walking, bathing, getting dressed or eating. Hospice care can help meet those needs.
In addition, dementia patients may lose control of emotions and become agitated, or they may even hallucinate. Their entire personality may change. In these scenarios, family caregivers may find that they are in need of hospice support to an even greater degree than their loved one, who may no longer fully comprehend what is happening.
Dementia is Highly Unpredictable
A challenge for family caregivers of dementia patients is that dementia can be highly unpredictable, compared with diseases such as cancer. The federal Centers for Medicare and Medicaid Services has established a life expectancy component to guide physicians in prescribing hospice care for dementia.
If the family of a dementia patient doesn't immediately qualify for the full range of hospice services, caregivers still have options available. Among 4,700 local hospice programs in the United States, some offer "bridge" or "transition" programs that provide some form of hospice service. Caregivers may inform doctors and other health care providers regarding levels of treatment to forestall unnecessary tests and procedures.
Also, caregivers may take part in advanced directives for end-of-life medical procedures, to the point of pursuing a formal "do not resuscitate" order.
Bottom line: When in doubt, family caregivers should contact their local hospice program.