Hospice is a unique approach used by healthcare professionals in providing caregiving to terminally ill patients. This type of care also aids the patient’s families. The primary goal of hospice care is to manage pain and other symptoms in the final six months of life.
Dementia is a condition in which a person’s cognitive functioning, such as reasoning, thinking, or understanding, has deteriorated to the point where it interferes with everyday life and activities. Many dementia patients cannot control their feelings, and the personality of those living with dementia may also change over time.
Alzheimer’s Disease is a type of neurodegenerative condition due to which the brain of the patient shrinks, leading to cell death over time. It is one of the most frequent forms of dementia, which is defined as a progressive loss of cognitive, behavioral, and social abilities that impact a person’s capacity to live independently.
Alzheimer’s Disease or dementia becomes more common as people age, but they are not a natural component of the aging process. Hospice care supports the patients and their families to cope with the end of life by easing pain, regulating illnesses, enhancing the quality of life, and decreasing distress and anxiety.
A team of highly trained clinicians, including physicians, nurses and their assistants, social services, clergy, counselors, and volunteers, are all responsible for providing hospice care. The hospice professionals can help the patient’s families by understanding the future possibilities due to Alzheimer’s/dementia progression. The majority of hospice care is given at a patient’s home or a care home.
Dementia And Alzheimer’s Disease
Memory lapses like misplacing belongings or having problems coming up with appropriate words and names are common in the early stages of Alzheimer’s Disease. The patient can still operate independently, although planning and organizing will become increasingly difficult for them.
As the person progresses to the moderate/middle stage, the patient will require more attention from the family members. The person starts to experience severe memory loss and disorientation at this point of illness. Sleeping habits and personality traits will change. This period is usually the longest, which lasts for several years.
Those with end-stage dementia will need around-the-clock assistance with their day-to-day activities. They lose track of recent events and their environment and have more difficulty communicating. Caretakers must anticipate their loved one’s demands at this stage, as this may be the start of facilitating hospice care to the patient.
Due to the gradual progress of Alzheimer’s Disease and other types of dementia, family members frequently get confused when the patient’s conditions require hospice care.
Hospice Eligibility Criteria For Those Living With Dementia
Those living with dementia must have a life expectancy of six months or fewer if the condition usually progresses to meet the hospice eligibility criteria. Whenever the person who is living with dementia’s physical state begins to deteriorate in the late stages, it may be the correct time to opt for hospice care. If you have any concerns whether or not your loved one is eligible for hospice, speak to your primary care doctor.
The eligibility criteria that may help the family members to decide this are listed below:
- A frequent increase in inpatient hospitalizations, doctor visits, and admission to the emergency room.
- A diagnosis of sepsis or pneumonia.
- Unable to sit erect without the use of armrests on chairs, or may slip out of them, necessitating the use of customized chairs.
- Unable to walk without aid, such as a walker, or now requires e a wheelchair
- Unable to sit up without assistance
- Inability of a patient to dress without any assistance.
Hospice Eligibility Criteria For Alzheimer’s Disease
Although Alzheimer’s Disease isn’t always fatal, it can cause major life-threatening complications which may necessitate home care or hospice care. Those with Alzheimer’s Disease require more attention and care than ordinary hospice patients.
Hospice caregivers with dementia knowledge and experience can assist the patients, and family members prepare for the future as Alzheimer’s progresses. These professionals shall also provide support throughout the end-of-life process.
Alzheimer’s Dementia usually progresses predictably.
Stage 1: The patient appears normal and does not have any functional decline
Stage 2: The patient appears normal, but the awareness declines.
Stage 3: The stage is called early Alzheimer’s, and one can notice the impact on day-to-day activities.
Stage 4: This stage is mild Alzheimer’s, and the patient requires assistance for doing specific tasks.
Stage 5: The patient requires dressing up and other daily activities.
Stage 6: This stage is called moderately severe Alzheimer’s, where a patient requires assistance in bathing, toileting, and other life activities.
Stage 7: This stage is severe Alzheimer’s, where a patient is unable to speak more than six words at a time, the patient is unable to walk, sit, or even smile properly. This stage is considered the most suitable stage when a patient’s family members should opt for Hospice care.
The eligibility criteria are listed below:
- The patient experiencing two or more episodes of pneumonia or any other bacterial illnesses in the past six months
- Patients having trouble eating & swallowing, which may lead to a 10% or more weight loss within six months.
- Patients having one or more unhealed skin pressure ulcers
Decision-Making For Opting Hospice Care
It can be challenging for doctors to determine how much time those who are living with Alzheimers have left or when they might enter hospice. It’s difficult enough to pinpoint precise times for anyone, but it’s even more difficult in the case with those who are living with dementia.
It’s difficult to decide whether one will require hospice care or predict if this care shall be the next step in therapy as dementia patients get sicker within a day. On the other hand, physicians serve as the “portal to hospice,” with rules/eligibility criteria helping them verify whether a patient’s sickness requires hospice care, and the patient has less than six months of life.
How Hospice Care Helps?
The hospice staff monitors those living with dementia or Alzheimer’s condition and adjusts the treatment plan when symptoms and the needs of the person change, even daily. Hospice’s purpose is to alleviate physical and mental suffering so that patients can maintain their dignity and remain comfortable.
For those living with dementia, hospice provides a wide range of care, including:
1. Care Plan Which Varies From One Person To Another
Those living with dementia lose their ability to communicate, due to which the hospital staff helps in relieving pain, diet, hydration, recurring infection, and agitation.
2. Provide Care
The care is provided to patients in hospitals, homes, or residential care homes, wherever required. Inpatient hospice services could provide round-the-clock treatment until the patient’s condition gets too severe to handle at home.
3. Integrated Care At All The Levels Of Diseases
A treatment plan is prepared with the patient’s neurologist or other physician’s guidance and consent. A manager assures that data is shared among all physicians, nurses, and if requested by patients. Furthermore, Hospice coordinates and supplies all the drugs, emergency aid, and equipment associated with the condition.
4. Emotional And Spiritual Support
Hospice has services to help people maintain their spiritual and psychological health.
How Hospice Care Benefits The Family?
Relatives may be forced to make complex financial and medical choices and may also be requested to work as caregivers and comfort others.
Families of people living with dementia can take advantage of a variety of hospice services, including:
The role of the family caregiver is critical in assisting the patient; that’s why it is essential to keep them informed and educated regarding the condition and how to handle it.
- The role of the family caregiver is critical in assisting the patient; that’s why it is essential to keep them informed and educated regarding the condition and how to handle it.
- Hospice can support family members in making difficult decisions that affect the health diagnosis or life quality
- Hospice provides spiritual and psychological support to loved ones.
- During hospice care, social services can support the families with personal finance and locating financial aid. If needed, doctors can assist mourning families in locating financial support through community health after the patient’s death.
- The hospice team works with the family after the patient’s death to help them communicate and manage their loss.
Conclusion
Hospice is a unique approach used by healthcare professionals in providing caregiving to terminally ill patients. This type of care also aids the patient’s families. The primary goal of hospice care is to manage pain and other symptoms in the final six months of life.
Dementia is a set of symptoms linked to a loss of memory, thinking, or even other cognitive abilities that interfere with one’s ability to perform daily tasks. Alzheimer’s Disease is a neurodegenerative brain illness caused by complex brain alterations because of cell destruction. It causes dementia symptoms, which get worse with time. In most cases, hospice patients are expected to live for six months or less. A doctor can make a clinical estimation of the average lifespan, but it varies from one patient to another.
The families also provide end-of-life care, which provides them satisfaction as they help in relieving the pain in the person living with dementia’s life. Those living with dementia frequently require repeated hospitalizations due to an infection or dehydration; this can be particularly difficult for Dementia and Alzheimer’s, as they are more likely to develop delirium or changes in behavior. For both patients and their families or caregivers, hospice can limit these transitions of care and improve quality of life.
References
- https://www.vitas.com/care-services/personalized-care-plans-by-diagnosis/alzheimers-disease-and-dementia
- https://pathwayshealth.org/hospice-topics/hospice-alzheimer%C2%80%C2%99s-patient-need-know/
- https://www.brightfocus.org/alzheimers/article/hospice-and-palliative-care-alzheimers-disease
- https://www.alz.org/help-support/caregiving/care-options/hospice-care#:~:text=Costs-,What%20is%20hospice%20care%3F,providing%20support%20to%20their%20family.
- https://www.vitas.com/for-healthcare-professionals/hospice-and-palliative-care-eligibility-guidelines/hospice-eligibility-guidelines/alzheimers-and-dementia
- https://www.nia.nih.gov/health/end-life-care-people-dementia
- https://www.mayoclinic.org/diseases-conditions/alzheimers-disease/symptoms-causes/syc-20350447
- https://www.nia.nih.gov/health/what-is-dementia#:~:text=Dementia%20is%20the%20loss%20of,and%20their%20personalities%20may%20change.
- https://www.alz.org/alzheimers-dementia/difference-between-dementia-and-alzheimer-s
