Support For Senior Caregivers
We understand the gratification, as well as the intense demands, of caring for a loved one with dementia. As the disease progresses, it can be difficult to manage dementia symptoms such as confusion and personality changes.
Senior caregivers have difficult decisions to make about their loved ones care. You also face major life decisions of your own such as needing to stop working or cut back on hours to meet the needs of a loved one with dementia. The stress can take a toll. Our specialized hospice program for dementia can help by:
- Exploring family needs and expectations
- Providing caregiver education and support, which allows senior caregivers to spend more time as a loved one and less time as a caregiver
- Supporting loved ones as they process grief, loss, anxiety, depression and other emotions
- Offering respite care, which gives caregivers a needed break to rest and recharge
Being Admitted To Hospice
It is true that another diagnosis can be the one that qualifies a person for hospice. In Dorothys case, she was otherwise healthy and without any other qualifying medical conditions, so when she stopped eating, and her physician believed and would certify she would live less than six months, he recommended hospice.
The additional support that hospice provides to the patient is just one of its benefits. The patients family and caregivers can benefit too. The hospice team is made up of a doctor, nurse, social worker, chaplain, caregivers, and volunteers. This team is available to caregivers during a loved ones time in hospice, as well as after they pass away. Grief and loss counseling are available both one-on-one, and in groups.
What Can Hospice Do For People With Dementia
Hospice teams evaluate dementia patients and develop a plan of care, which is adapted as their symptoms and conditions change.
This plan is developed with the advice and consent of the individuals doctors, and the hospice team works to coordinate communication so that all parties involved are on the same page. Their goal is to alleviate the physical and emotional distress that dementia patients often suffer and maximize their comfort.
Some of the factors addressed by the patients individualized care plan include pain, nutrition, skincare, agitation, feeding, hydration, and recurrent infection. Hospice also provides medical supplies, equipment, and medication-related to the patients diagnosis.
In addition, hospice provides emotional and spiritual assistance to patients as they navigate this complicated stage of life. This often includes volunteers to provide social support and conversation, chaplains for exploring religious and spiritual questions, and other therapies such as massage therapy or music therapy.
Hospice care is given to patients wherever they live, whether it is in their home, an assisted living community, or a long-term care facility.
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How Long Can You Be In Palliative Care
Time ranges for receiving palliative care can vary dramatically from patient to patient and have no set duration. While patients may begin palliative care as soon as they have received a diagnosis of a serious illness, it will typically coincide with pursuing treatments and a cure for their ailments. As a patient’s health improves and they overcome an illness, they can move out of palliative care. Alternatively, a patient with a chronic disease may move in and out of palliative care with fluctuations in their health. With this in mind, palliative care is a service that could potentially be provided for a few months to even several years. Since these timelines can be fluid and unpredictable, palliative care in the home can be an excellent option.
How Hospice Care At Home Helps With Dementia
Every familys journey is different. Well work with you to create a hospice care plan that focuses on what matters most to you and your loved one. Elderly people with dementia receive care from a compassionate team of nurses, social workers, hospice aides, chaplains, bereavement counselors and trained volunteers, in conjunction with their doctor. Our dementia specialty hospice program offers:
- Pain and symptom control so older adults with dementia can spend quality time with their caregivers and loved ones
- Nonverbal pain and behavior assessment
- Medical care, including visits by a nurse, for acute conditions like infections, behavioral issues and breathing difficulties
- Help with nutrition and specialized feeding needs
- Skin assessment and protection
- Help with bathing, grooming and personal care from a hospice aide
- Medications, medical equipment and supplies related to dementia
- Spiritual support with a hospice chaplain
- Emotional support and resources for the patient and family from a hospice social worker
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Management Of Pain And Other Symptoms
Addressing pain and other symptoms in the early stages, rather than waiting until they become severe, is a priority. Therefore, it is crucial to begin hospice care as soon as one is ready and meets the eligibility requirements. Hospice care teams always work to manage the patients pain as expediently and efficiently as possible.
In addition to determining the appropriate medications for pain and other symptoms, members of the care team also get creative when identifying the best ways to administer the treatments. Finding new therapies, new uses for conventional medications and new techniques for improving comfort care is an ongoing goal for these medical professionals, therapists and volunteers. Here at Moments Hospice we have a wide variety of extra therapies we cover at no additional cost.
Special needs are best handled by specialists. Hospice professionals specialize inend of life care and should be called upon during the first stages of a terminal illness to ensure the patient and their family members can benefit from all the services hospice has to offer.
Hospice Eligibility Criteria For Dementia:
In order for a dementia patient to meet the hospice eligibility criteria, he or she must have a life expectancy of six months or less if the disease continues in its typical progression. For patients with dementia, it may be time to consider hospice when the patients physical condition begins to decline. Some key things to look for include:
- A diagnosis of other conditions as COPD, CHF, cancer or congenital heart disease
- An increase in hospitalizations, frequent visits to the doctor and/or trips to the ER
- A diagnosis or pneumonia or sepsis
- Weight loss or dehydration due to challenges in eating/drinking
- Speech limited to six words or less per day
- Difficult swallowing or choking on liquids or food
- Urinary and fecal incontinence
- Unable to sit upright without arm rests on chairs or may slip out of chairs and require sitting in special chairs
- Unable to walk without assistance such as a walker or now requiring a wheelchair
- Unable to sit up without assistance
- No longer able to smile
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Some Hospice Providers Specialize In Dementia Care
While all hospices have the ability to provide care for someone with dementia, there are providers that actively specialize in this field. These hospices typically have tailored programs that are designed to support everyone involved in the life of a patient affected by this disease and help them cope with the unique challenges it brings.
Regardless of a programs specialty, Fields Lawler suggests that family caregivers ask the following questions of potential providers to help ensure their loved ones will receive the highest level of care:
Fields Lawler also emphasizes the importance of finding a provider that is staffed with well-trained and loving hospice nurses and aidesthe unsung heroes of these end-of-life programs. These people will spend the most time with your loved one and help them complete the most intimate tasks like bathing, dressing and toileting. Many individuals with dementia have a fear of water, so having patient aides with a keen understanding of this disease is a must.
When To Seek Out Hospice Care For A Senior With Dementia
A great deal of uncertainty and misinformation surrounds hospice care and many families hesitate to discuss the option with physicians and their loved ones. Fields Lawler urges families to learn and talk about this valuable resource even if it isnt needed at the moment.
I am a big advocate for early hospice/palliative care intervention, she explains. I believe that if a family caregiver is thinking their loved one needs help, has questions, and needs guidance, then that is the time to seek out assistance. It is never too early to begin gathering information and forming a plan as a family. Hospice exists to support patients as well as their family members throughout this trying time.
Because those with dementia decline so gradually, family members may not seek help until their loved ones are very close to the end. Many do not realize that assistance and specialized care may have been available much earlier. While a physician must make the official determination of life expectancy, Fields Lawler recommends requesting a hospice evaluation if an individual with dementia exhibits the following signs:
- Constant, elevated levels of anxiety and stress;
- Complete dependence on others for assistance with activities of daily living , such as eating, bathing, grooming and toileting;
- Extreme difficulty or complete inability to walk without assistance; and
- The ability to only speak a few intelligible words and phrases.
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At What Point Do Dementia Patients Need 24 Hour Care
When living at home is no longer an option
There may come a time when the person living with Alzheimers disease or dementia will need more care than can be provided at home. During the middle stages of Alzheimers, it becomes necessary to provide 24hour supervision to keep the person with dementia safe.
Where Is Palliative Care Provided
Palliative care can be provided in hospitals, nursing homes, outpatient palliative care clinics and certain other specialized clinics, or at home. Medicare, Medicaid, and insurance policies may cover palliative care. Veterans may be eligible for palliative care through the Department of Veterans Affairs. Private health insurance might pay for some services. Health insurance providers can answer questions about what they will cover.
Visit the National Hospice and Palliative Care Organization website to find palliative care near you.
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Hospice Care Helps Families Too
What many people dont know is that hospice care offers families much more support than they get under traditional medical care.
Families benefit from:
- Having hospice professionals on call 24 hours every day
- Not needing to go to the doctors office because nurses visit the home
- Getting help with bathing and other personal care tasks
- Reduced costs typically, hospice care is less expensive than hospital stays or ER visits
- Family guidance, support, and grief counseling
South Nj Hospice Care For Dementia
The Alzheimers Association estimates that nearly 50 million people are living with Alzheimers disease or other dementias worldwide and nearly 16 million Americans provide unpaid care for their loved one living with the disease.
Caring for your loved one with end-stage dementia is challenging. Hospice can help you. Hospice care for dementia in South Jersey is special care that provides comfort, support, and dignity at the end of life. It addresses physical, emotional, social, and spiritual needs, aids you the caregiver in providing hands-on care, and offers a team approach to maintaining quality of life.
Samaritan cares for many patients with end-stage dementia each year and has been the premier hospice provider in South NJ since 1980.
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When To Call Hospice
Due to the slow progression of Alzheimers disease and other dementia, it can be difficult for family members to determine when a patient becomes eligible for hospice care. This is why the conversation about hospice should happen early on. This way you have a plan in place should the hospice eligibility criteria for dementia be met.
Crossroads Hospice & Palliative Care is available to assess the patient in their home environment to determine whether they meet the hospice care requirements for dementia. We are happy to meet with families at the time and place most convenient for them.
To arrange a hospice consultation, please contact us at 1-888-564-3405. Our team is available 24 hours a day to take your call.
When Is It Time Hospice For Dementia Patients
Caring for someone with dementia is one of the hardest jobs there is. Dementia impacts a persons memory, their ability to care for themselves and eat, and their personality and behavior. Alzheimers disease is probably the most well known cause of dementia, however other diseases such as Parkinsons and vascular disease as a result of strokes can lead to a similar clinical picture. Dementia can take a toll on a persons mind and body for years before ultimately resulting in death. These years can be very challenging for those caring for these individuals. The job can be physically and emotionally taxing on the caregiver. Furthermore, resources to assist these patients and their families are often limited.
Hospice of the Panhandle receives several calls a month inquiring about our services for patients diagnosed with dementia. Some of those meet Medicares eligibility criteria, while others do not. That does not change the fact that these patients and their families need help.
The Medicare guidelines for hospice eligibility for Alzheimers dementia advise to look for the following to be present:
The patient is unable to or requires much assistance with activities of daily living ;
The patient is incontinent of bowel and bladder, and has one or more of the following limitations:
The patients speech is limited to 0-6 words in the course of an average day/conversation;
The patient has lost the ability to walk;
The patient cant sit up without support;
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Hospice Criteria For Dementia
More than 5 million Americans are currently living with Alzheimers disease and related dementias and more than 15 million family caregivers are providing unpaid support to their loved ones with Alzheimers or other dementia.
In the early stage of Alzheimers disease, individuals will experience memory lapses such as misplacing objects or having trouble coming up with the right word or name. They are still able to function independently, but will have increasing trouble with planning and organization.
As the individual reaches the moderate/middle stage, they will begin to require more care. It is during this time that the individual begins to experience more severe memory loss and confusion. They may be unable to remember names be confused about where they are. Some individuals in this stage may need help remembering to dress appropriately for the weather. There will be changes in sleep patterns and personality. This stage typically lasts the longest often for several years.
In end-stage dementia, individuals will require 24-hour assistance with daily living. They lose awareness of recent experiences and their surroundings and have increased difficulty communicating. Individuals with late-stage Alzheimers become vulnerable to infections, especially pneumonia. During end-stage dementia, it is important for caregivers to anticipate their loved ones needs as they may even forget how to suck from a straw or how to swallow.
For Patients Speaking To Families
Education is key. Educate yourself first. By now, youve probably done some research on this website. It might also be helpful for you to learn some common misconceptions about end-of-life care, as your family may be misinformed about the realities of hospice. View our video on dispelling hospice myths. Read and share “Considering Hospice: A Discussion Guide for Families” at HospiceCanHelp.com;
Determine what your loved ones know. Before bringing up hospice, make sure your loved ones have a clear understanding of your health status. People handle difficult information in different ways. If family members are not accepting or understanding of your prognosis, you might want to have your physician, clergy or a trusted friend speak with them on your behalf.;
Discuss your goals for the future, as well as theirs. As a patient, your greatest concern might be to live without pain, or to stay at home, or to not become a burden. Ask your loved ones what their concerns are when they consider the coming months, weeks and days. Explain that hospice is not giving up. It is an active choice to ensure that everyones needs are met.;
Take initiative. Remember, its up to you to express your wishes. Sometimes, out of concern for your feelings, your family or loved ones might be reluctant to raise the issue of hospice for you.;
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Weighing Hospitalization Against Hospice At The End Of Life
As a loved ones condition declines due to dementia, the likelihood of developing complications, such as aspiration pneumonia, pressure ulcers and urinary tract infections , increases greatly. Family members must decide whether to seek curative treatment at the hospital for conditions like these, which can be mentally and physically taxing on a person who is cognitively impaired. Sadly, even if secondary health issues resolve, it is probable that they will recur. The difficult question is, should families forgo treatment in the hospital and opt for comfort care? If so, when?
The answer lies in your loved ones personal end-of-life preferences. Hopefully this was a conversation that took place early on while they were still mentally competent and resulted in appropriate planning measures such as a living will, a do not resuscitate order, a voluntarily stopped eating and drinking , POLST form, or advance directive. If our loved ones wishes have been documented, then it is up to us as their caregivers to follow them.
Because late-stage dementia prevents patients from effectively clearing bacteria from the body and notifying others of their symptoms or pain, infections can easily take root and are often the cause of death. Urinary and fecal incontinence, difficulty swallowing and breathing, and overall reduced immune system function all contribute to illness.