Unlike other serious and terminal illnesses, dementia related illnesses can be very difficult to determine whether and when hospice should be utilized. Illnesses involving cognitive decline do not follow the same stages of progression typically measured to determine whether hospice care is appropriate. Hospice programs provide comfort and dignity to the dying process for the patient and family members. Those suffering from diseases like heart failure, stroke, sepsis or liver failure typically know more about hospice’s offerings and understand when to initiate that type of palliative care.
Family members and caregivers of dementia patients have a much harder time deciding to call in hospice. Even the doctors and medical staff struggle with the decision in many cases. To qualify for most hospice programs, an individual must have a terminal health condition and a life expectancy less than 6 months. For patients to be admitted under Medicare’s guidelines, the treating physician must assess a dementia patient and determine whether he or she falls into one of the following two categories:
- The patient ranks at least a 7 on the FAST scale. The stages rank dementia symptoms in 7 stages so this ranking is the most severe offered on the scale. It indicates the patient suffers from incontinence and is unable to walk, dress or use the restroom without assistance.
- The patient has comorbidities, or other significant illnesses alongside the dementia diagnosis. Often these comorbidities include sepsis or pneumonia.
While a physician must use the above-mentioned criteria to determine an official life-expectancy, caregivers may begin researching options prior to the official 6-month life expectancy determination. A hospice evaluation may be conducted if the patient exhibits any of the following signs:
- Complete dependence on others for common ADLs (activities of daily living) such as eating, grooming and using the restroom.
- Loss of mobility or the inability to walk without assistance.
- Difficulty speaking and communicating.
- Persistent anxiety.
Individuals suffering from dementia progress gradually and each case is unique. It can be extremely difficult to assess when the benefits of hospice can be utilized, but in many cases, it may be sooner than most realize. Getting the right information and communicating your preferences to the treating physician can help speed up the process.
For more information on elder law issues such as Medicare and Medicaid enrollment, estate planning and long-term care planning including the incorporation of hospice services, reach out to the elder law attorneys at Stouffer Legal in the Baltimore area for a consultation. You can schedule an appointment by calling us at (443) 470-3599, emailing us at office@stoufferlegal.com, or register for an upcoming free webinar using the link below:
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