When Is It Time For Hospice With Dementia

What Are The Signs Of End

It is important for caregivers to know when an individual with dementia is close to the end of their life, because it helps ensure they receive the right amount of care at the right time. It can be difficult to know exactly when this time is due to the variable nature of dementias progression, but understanding common end-of-life symptoms of seniors with dementia can help. Below is a timeline of signs of dying in elderly people with dementia:

Final Six Months

• A diagnosis of another condition such as cancer, congestive heart failure or COPD
• An increase in hospital visits or admissions

Final Two-to-Three Months

• Speech limited to six words or less per day
• Difficulty in swallowing or choking on liquids or food
• Unable to walk or sit upright without assistance

• Hands, feet, arms and legs may be increasingly cold to the touch
• Inability to swallow
• Terminal agitation or restlessness
• An increasing amount of time asleep or drifting into unconsciousness
• Changes in breathing, including shallow breaths or periods without breathing for several seconds or up to a minute

Patients with dementia are eligible to receive hospice care if they have a diagnosis of six months or less to live if the disease progresses in a typical fashion. Once a patient begins experiencing any of the above symptoms, it is time to speak with a hospice professional about how they can help provide added care and support.

Shes Experiencing Almost Constant Anxiety

Even if your elderly family member doesnt communicate in the same ways that youve always been used to, you can likely tell that shes feeling stressed or anxious. That stress and anxiety can come from the changes that shes experiencing. Theres a lot that shes lost control over, and even if she cant explain that frustration, she still feels it. Having some experienced help to manage her needs can be really helpful both for your senior and for you.Hospice care providers can help your elderly family member to be as comfortable as possible while getting the care that she needs.

If you are considering hospice care in Folsom, CA, for an aging loved one, please contact the caring staff at PIC Comfort Care today. Call 885-9948.

What Is The Hospice Dementia Fast Scale

The FAST scale is what hospice uses to determine if a dementia patient is ready for their care. A dementia patient needs a score of seven to qualify for hospice. The testing scale measures the mental well-being of those who have dementia essentially by measuring how slow their response time is in critical areas. When a patient is at stage seven on the FAST scale, they will no longer be able to walk, eat, sit up, move their head, speak more than several words per day, or smile.

If youre currently caring for a loved one who has dementia and you think theyre ready for hospice, contact Hospice Care of Central Georgia. We have a team of loving and professional caregivers who specialize in caring for those with dementia. Even if they arent ready for hospice, we offer palliative care to help them through the entire process.

Read Also: Is Alzheimer’s A Multifactorial Disorder

Questions To Ask About End

As a caregiver, you will want to understand how the available medical options presented by the health care team fit with the needs of both the family and the person with dementia. You might ask the health care team questions such as:

• Who can help me with end-of-life care for my loved one living with dementia?
• How will your suggested approaches affect their quality of life?
• What are my options if I can no longer manage the care of my loved one at home?
• How can I best decide when a visit to the doctor or hospital is necessary?
• Should I consider hospice at home, and if so, does the hospice team have experience working with people living with dementia?

Tips For Managing Dementia End

Because individuals with advanced dementia will often have difficulty communicating, it is important that caregivers keep a close eye on their loved one for signs of pain or discomfort. These signs may include moaning or yelling, restlessness or an inability to sleep, grimacing, or sweating. This may also signal that its time to call hospice or a palliative care team to help with the pain management.

If an individual with end-stage dementia is having trouble sitting up without assistance, hospice can provide a hospital bed or other equipment to lift their head.

Perhaps the hardest thing for families is when a loved one with dementia is no longer able to eat or swallow. Because an individual with dementia is unable to understand the benefits of feeding tubes or IV drips, they will often be incredibly distressed and attempt to remove them, causing added pain and risk of infection. Instead, focusing on keeping the individual comfortable. Supporting them with mouth care to prevent their mouth from becoming dry will allow them to make their final transition in peace.

Also Check: What Is Vascular Dementia Disease

Palliative Care For People With Dementia

There is no one answer to the question of when palliative care should begin for someone with dementia because the decision is made by the person, their loved ones, and the circumstances. As a result, even after dementia diagnosis, palliative care can be beneficial, and it may include symptom management, prognosis and goals of care discussion, determination of code status, and psychosocial management. Hospice care is covered by Medicare for people with original Medicare or a Medicare Advantage plan in the final months of life.

Support For Carers And Family

Coming to terms with the impending loss of someone you may have helped care for over a period of time is difficult and upsetting.

Talk to the healthcare professionals about your own concerns and wishes. These may include reassurance that the person’s pain is being properly managed or the need to be with them at the end of their life.

After the death of a loved one, you’ll experience bereavement in your own way. It’s important that you’re supported in this process.

Read Also: The Causes And Effects Of Alzheimer’s Disease

Hospice For Dementia: When Is My Loved One Eligible

Dementia is a heartbreaking condition to witness. Seeing your loved one change as they experience confusion, frustration and depression, slowly losing touch with reality, is difficult to bear.

As a caretaker, you are aware of how things change daily. When your loved one becomes more challenging to look after, you may wonder what options are available. Quality of life is something you consider as their condition worsens.

While skilled nursing or in-home care are standard options while your loved ones physical health is still in good shape, its hard to know when its time to turn towards end-of-life care.

If you are looking at a hospice for dementia, you may be wondering if your loved one is eligible for care.

Contrary to the misconceptions, hospice care is available for patients with dementia. There are hospice criteria for dementia that your loved one has to meet to admit your loved one, and unfortunately, there isnt a single rubric for patients with this illness. Follow along as we discuss some of the guidelines for admitting a patient with dementia into hospice.

How Dementia Complicates Hospice Eligibility

Estimating how long a person has to live is nearly impossible. It simply cannot be done with absolute accuracy in most cases, but a general idea is required in order to establish a persons eligibility for receiving hospice care. To qualify for most programs, an individual must have a terminal health condition and a life expectancy of six months or less. However, not all life-threatening diseases progress predictably. Any dementia caregiver can attest to the fact that a loved ones condition can improve or worsen on a daily basis. Fortunately, physicians and hospice staff who are knowledgeable about dementia, especially in the later stages, can help families determine when it is time to seek out comfort care.

Dementia can complicate the eligibility process for hospice but taking a persons personality prior to their diagnosis into consideration can help, explains Meredith Fields Lawler, LCSW, Director of Outreach Programs at the Crossroads Hospice Charitable Foundation based in Tulsa, Oklahoma.

Fields Lawler recalls a patient many years ago who had Lewy Body dementia and whose daughter was experiencing an immense amount of stress over the worsening of his symptoms. He would often lose track of time, and it had become hard to hold his attention. The daughter and I sat together and through tears she told me about what her dad was like while she was growing up.

Read Also: Does Alzheimer’s Change Your Appearance

What Are The Symptoms Of Dementia Towards The End Of Life

Dementia is progressive, which means it gets worse over time. In the last year of life, its likely to have a big impact on the persons abilities including memory, communication and everyday activities. The speed at which someone will get worse will depend on the type of dementia they have and who they are as an individual.

Check Their Advance Care Plan

You should find out if the person has an advance care plan. This document may record their preferences about the care theyd like to receive, including what they want to happen, what they do not want to happen and who they want to speak on their behalf. It may include an advance statement or an advance decision. We have information on planning ahead for patients and their families, which you might find useful.

Recommended Reading: Signs Or Symptoms Of Dementia

Caregiver Education And Support

Family caregivers are vital in helping hospice professionals provide the best experience for patients. As the patient becomes weaker, communication becomes increasingly more difficult. Its important that caregivers are prepared for this. Our hospice care team prepares families for this decline and teaches them how to best support their loved one. Were by your side in caring for them and will ensure you and your family are also cared for throughout this process.

Caring For Someone With Dementia Towards The End Of Life

Please be aware – this information is for healthcare professionals. We also have information for the public.

You can use our My Learning form to reflect on how this page has helped with your continuing professional development.

People with dementia may experience problems with thinking, memory, behaviour and mobility. It can be difficult to recognise when someone with dementia is nearing the end of their life. You can support the person by communicating with them and helping them with any symptoms they have. If possible, its a good idea to plan the persons care in advance to help understand what they want from their care.

On this page:

You May Like: Is It Possible To Get Alzheimer’s As A Teenager

Support For People With Dementia And Carers

UCL covid-19 decision aid a tool to support carers of people living with dementia to make difficult decisions during covid-19

Alzheimers Society end of life care information for patients and families

Alzheimers Society information and fact sheets on all aspects of dementia including what is dementia, types of dementia and living well with dementia

Alzheimer Scotland specialist services for patients and carers

Dementia UK expert one-on-one advice and support to families living with dementia via Admiral Nurses

Comparison Of The Features Of Palliative And Hospice Care

While there are no restrictions on who can receive palliative care, hospice care has some eligibility restrictions. The patients doctor and the hospices medical director must certify that the individual has a terminal illness and has six months or less to live if the illness is allowed to run its course. To receive Medicares hospice benefit the patient also must be eligible for Medicare Part A, agree to choose hospice care instead of regular Medicare benefits to treat the terminal illness, and receive care from a Medicare-approved hospice program.

Like palliative care, hospice care teams consist of specially-trained nurses, physicians, social workers, physical therapists, dieticians, and pharmacists. However, the hospice team will also usually include chaplains and volunteers. In addition, a home health aide may come to assist with bathing, dressing, or feeding. Most hospice care is provided in the patients home. However, there are hospice programs located in many assisted living and skilled nursing facilities as well as hospital-based and residential programs.

• Physician services
• Short-term inpatient care
• Short-term respite care

Recommended Reading: When A Person Has Alzheimer’s

Your Family Member Is Unable To Perform Adls On Her Own

ADLs, or activities of daily living, are central to successfully living on her own for your senior. These are activities like eating, getting dressed, and using the bathroom. People can live independently for quite a while having extra help with these tasks. If your elderly family member is at a stage where she cannot perform any part of these daily activities on her own, then it may well be time for more comprehensive care.

When To Choose Hospice For Dementia

Dementia is a slow-progressing disease that can take years, if not decades, to take effect. Symptoms will start slow and gradually progress as the condition worsens. You must receive a dementia diagnosis as early as possible so that you can properly monitor your loved one.

Knowing that youre caring for a dementia patient allows you to understand the signs and symptoms to watch out for. You must have conversations with hospice caregivers early on so that they can advise you as to when its time to call them.

You May Like: Activities To Do With Elderly Dementia

When To Seek Hospice For Dementia Or Alzheimers Patients

With the slow decline of dementia and Alzheimers disease, it can be difficult to decide when the right time for hospice is. While only a doctor can make a clinical determination of life expectancy, generally, patients in hospice have less than six months to live.

There are common signs that can help you determine if now is a good time for hospice care, such as:

• The person can no longer walk and is bed-bound
• The person can only say a few words
• The person is dependent on others for dressing, eating and grooming
• The person shows severe signs of anxiety

If your loved one is experiencing one or many of these signs, it might be time to consider hospice care.

Is Hospice Good For Dementia Patients

Since dementia is progressive, the symptoms might start off manageable enough, but there will be a slow decline and worsening cognitive impairment over time.

That brings us to hospice.

Hospice, if you need the definition, is end-of-life care for someone who has a terminal illness. Is this really the right option for a dementia patient or are they better off in a nursing home or an assisted living facility?

Hospice programs are absolutely an appropriate choice if your senior has advanced dementia. Through around-the-clock professional medical care by the hospice team, your parent or loved one will recover some quality of life in their last months.

The quality of life for family caregivers will improve as well. There is a lot of emotional stress that goes along with worrying about a loved one all the time.

As we mentioned in the intro, they could be partaking in dangerous activities such as trying to leave the house in the middle of the night or turning on the stove. Whats worse is they dont even realize what theyre doing.

Youll still be able to regularly visit your parent or loved one while theyre in hospice, but their care will no longer be a worry or burden for you to bear.

Don’t Miss: Is Earwax Linked To Dementia

How Can I Support Someone With Dementia Towards The End Of Life

Knowing the person will make it easier to provide person-centred care that is focused on what they need and want. It can help to know about their likes, dislikes and their wishes for how they want to be cared for. If the person is not able to tell you about themselves, speak to their family, friends or other people who know them well.

Its a good idea to find out if the person has a copy of This is me , a document that records information about themselves. If you cannot speak to the person, ask those close to them if they have a copy. They may have these details recorded in their care plan.

There are many ways to support someone with dementia at the end of life.

How Long Do Dementia Patients Live On Hospice

Lets say the dementia patient in your life was given a doctors prognosis of six months. Once theyre in hospice care, is there a possibility they could live longer?

Yes, but more than likely, it wont happen. Thats only because, as we said before, dementia is progressive.

Although its possible that your loved one could have been in the middle stages of dementia for several years, once they reach the third stage of the disease, their body begins shutting down. At this point, the end of life is not far off.

If they can barely get food or drink down without choking and theyre speaking very infrequently, those are also signs that the disease has advanced quite rapidly.

In the last days and weeks of their lives, a dementia patient will usually experience these symptoms:

• Breathing changes, such as very fast breathing for a few seconds, then slower and shallower breaths, followed by faster ones
• Barely being able to stay awake and even being unconscious instead of asleep
• Cold legs, arms, feet, and hands

Its worth mentioning that not every dementia patient follows these stages to the letter. Their symptoms might appear sooner or later than what is common, but many dementia patients generally experience the same symptoms at the end of their life. Thats how the FAST Scale was able to be developed.

Recommended Reading: Folic Acid And Alzheimer’s