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Hospice Care for Alzheimer’s Patients Near the End of Life: Answers to Top 10 Questions
When we think of hospice care, we often associate it with cancer patients, but it is 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 start considering hospice if the patient is in an advanced stage of the disease. In advanced Alzheimer’s disease the patient is unable to walk, dress or bathe without help; have problems 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 Geriatrics Society, if your loved one with advanced Alzheimer’s shows any of the following symptoms, you may want to talk to your loved one’s doctor. on 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 nutritional support, that results in weight loss of 10% or more over the previous 6 months.
- One or more skin pressure ulcers that do not heal
10 Frequently Asked Questions About Hospice Care:
- What is hospice care? Hospice care is a team-oriented, compassionate approach to caring for terminally ill patients that focuses on improving the quality of life and reducing pain and discomfort. It strives to help patients live their last 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, independent hospice facilities or hospital hospices.
- 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? Mainly medical and nursing services; physical, occupational and speech therapy; medical social services; home health aide and homemaker services; counselling; short-term inpatient care; prescription drugs; and medical devices 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 matters related to 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 mind? Yes, you can stop at any time for any reason. You can also reinstate hospice care later if you wish.
- How can I find a reputable hospice care agency? You can get referrals from family members or friends; a hospital social worker, discharge planner or care manager; your doctor; 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 websites: 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 that it will help you and your loved one have the highest possible quality of life during the precious time that remains.
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