As a patient’s dementia progresses, they will experience a decline in their physical and mental abilities. This can lead to an inability to communicate, a reduction in mobility, and overall decrease in their quality of life. When these changes become too severe, hospice care is often suggested. Hospice care is designed to make the patient as comfortable as possible, providing palliative care for the patient’s remaining days.

Palliative Care: relieving symptoms without addressing the causes of a condition

Hospice: focusing on palliative care for the patient as well as addressing emotional and spiritual needs for the patient and family at the end of life

When choosing hospice care for a patient with dementia, it is important to consider their preferences and wishes. It is also important for you to recognize that hospice does not mean giving up on your loved one. Instead, it is about providing comfort and care for the remainder of their life — and giving the necessary emotional support for you and their loved ones.

When to begin hospice care

It is usually difficult to predict exactly how long a person will live. In most cases, length of hospice cannot be determined precisely, but a rough estimate is possible. Most programs require clients to have a terminal health condition and life expectancy of six months or less. Not all terminal illnesses, however, advance predictably.

Signs your loved one may be ready for hospice care include:

• Inability to ambulate (move around) without intensive assistance
• Difficulty eating, speaking, and drinking on their own
• Inability to bathe or clean themselves
• Severe incontinence (inability to control bladder & bowel movements)
• Profound deficits in memory

Additional medical conditions that may come up during end-stage dementia include, but are not limited to:

• Frequent infections, including up to septicemia
• Febrile episodes: fever-induced seizures
• Pneumonia
• Abnormal breathing patterns
• Increasing number of hospitalizations and trips to the doctor or emergency department

Any dementia caregiver can tell you that a loved one’s health can improve or worsen daily, and even with guidance, it may be difficult to individually assess when it’s time to transition to hospice care. Fortunately, doctors and other geriatric professionals can assist families in determining when it is appropriate to seek care. If you are ever unsure, you can always consult your loved one’s physician.

One assessment healthcare professionals will often use is the FAST scale to determine if it’s time to transition a patient’s care to the hospice stage.

What exactly is hospice care?

Hospice is a unique manner of caring for terminally ill patients and supporting their families. The primary goal of hospice care is to manage pain and other symptoms during the last few months of life, with treatments focusing on comfort rather than any treatment or cure. The goal of hospice is to ease pain and maximize comfort.

A team of professionally trained caregivers provides hospice care, including physicians, nurses, home health aides, social workers, counselors, clergy, and volunteers. Family members are often heavily involved in caregiving as well.

Hospice teams offer the following types of care:

• Medication and medical equipment used to relieve symptoms and pain
• Assistance and equipment to help the patient with ADLs, such as bed pans or injections for administering medication
• Emotional and spiritual end-of-life guidance and counseling
• Educational support to at-home caregivers
• Family bereavement assistance and respite care

Most hospice care is delivered at home or in a nursing home. Some places also have free-standing hospice institutions and hospice units inside hospitals.

What does hospice care offer?

Hospice workers assess dementia patients and create a unique, individual care plan that is adjusted as their symptoms and circumstances change.

The hospice team works to organize communication so that all parties involved are on the same page. This plan is prepared with the advice and cooperation of the individual’s physicians and caregivers. The hospice team works to coordinate communication so that all parties involved are on the same page.

Volunteers are often included to provide social support and discussion, clergy to explore spiritual questions, along with other miscellaneous treatments and care, such as music or art therapy.

Patients receive hospice care wherever they reside, whether at home, in an assisted living community, or in a long-term care facility.

Conclusion

In conclusion, hospice care provides an opportunity for those suffering from dementia to receive the optimum comfort and care at the end of their lives. Hospice can provide palliative treatments tailored to each individual patient’s needs, as well as emotional and spiritual guidance for both the individual and their family. Hospice care can ultimately help ease an individual’s pain and suffering, as well as to provide invaluable support to the loved ones in their life.

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