Hospice and the Alzheimer’s Patient: What You Need to Know
Alzheimer’s patients require more care and skilled attention than the average hospice patient. Hospice providers with expertise and experience in dealing with dementia can help patients and families understand what to expect in the final stages of Alzheimer’s, offering support throughout the end-of-life process, says the Alzheimer’s Association.
While Alzheimer’s Disease isn’t necessarily a death sentence in and of itself, it can come with some serious life-threatening issues that may require home care or hospice care. The Huffington Post says to watch out for these signs to discuss with your loved one’s doctor. They may suggest hospice care as a result.
- Two or more episodes of pneumonia or other serious infections in the last six months
- Difficulty eating and swallowing resulting in weight loss of 10% or more over the last six months
- One or more skin pressure ulcers that will not heal properly
Stages of Alzheimer’s Dementia
Generally, there’s a clear progression with Alzheimer’s Dementia. Your loved one’s healthcare provider will know the steps. Here’s an overview of that progression as part of dementia care:
- Stage 1: Appears normal, no functional decline
- Stage 2: Appears normal, personal awareness of functional decline
- Stage 3: Noticeable effects at work; considered early Alzheimer’s
- Stage 4: Considered mild Alzheimer’s, needs help with certain tasks
- Stage 5: Moderate Alzheimer’s; needs help dressing
- Stage 6: Moderately severe; requires help bathing, toileting, is incontinent
- Stage 7: Severe; can’t speak more than about six words; cannot walk, sit up, hold up head on own, or smile.
In general, patients who are exhibiting Stage 7 symptoms are considered candidates for hospice. Your loved one may enter hospice at earlier stages if deemed necessary by a physician.
The early signs of Alzheimer’s may start with memory problems, then progress bit by bit to difficulty remembering names, trouble speaking, increased infections, inability to use the bathroom or walk on their own, as well as agitation. Final stages will see the Alzheimer’s patient sleeping a lot, curled in a fetal position, bed-bound, unable to swallow and unwilling to eat.
Making the Decision for Hospice
However, it can be tough even for physicians to determine exactly how much time an Alzheimer’s patient has left and when they should enter hospice. It’s tough enough to pinpoint exact times for anyone with any disease, more so with dementia. Because people with dementia get sicker inch by inch, it’s hard to say with any degree of certainty when hospice should be the next step, says the New York Times. That being said, doctors act as the “gateway to hospice,” with Medicare regulations requiring them to certify that a patient is likely to die of the disease within six months. Diseases like heart disease and cancer have more clear-cut paths than Alzheimer’s, which is why it’s so difficult.
As a result, many Alzheimer’s patients go without the comfort, pain control, fewer hospitalizations and higher family satisfaction that hospice can offer. Under-enrollment for Alzheimer’s Disease within hospice is a sad fact. However, with the proper diagnosis and the hospice or home health care team working together to make that decision, this number can get higher.
Benefits of Hospice Care for Alzheimer’s Patients
Like all hospice patients, hospice care providers offer end of life care, comfort, and pain and symptom control for any factors underlying the disease. Quality of life is the big factor here. Also inherit in hospice care is a variety of sensory connections such as hearing, touch, or sight that are designed to bring comfort, says the National Institute on Aging. For example, massage can be soothing, as can music therapy for relaxation, which is particularly helpful for those who tend to get restless as night approaches. This is called sun downing and is common in many dementia patients.
Medicines for pain and symptom control are another big part of hospice for the Alzheimer’s patient. These medicines may delay symptoms from becoming worse, reliving their pain or discomfort for a time. Other medications can control behavioral symptoms. Not all hospice services are for the patient. Some are geared towards family members. Caregiver stress is a very real and tangible thing for family members, who may suffer from burnout and depression after caring for a loved one who may not even recognize them anymore.
Contact Pathways Home Health and Hospice
Do you have a loved one suffering from Alzheimer’s? Do you suspect it’s time for entry into hospice? Have a conversation with your loved one’s healthcare provider and home health care team to go over the reasons why. Pathways Home Health and Hospice is here to help, with skilled dementia care professionals who can provide insight into this matter. Contact us now to learn more at 888-755-7855. Lean on us for help.