Hospice Care for Those With Alzheimer's
Hospice care eligibility guidelines state that it is appropriate for any person who has a life-threatening or terminal illness. Most reimbursement sources require a prognosis of six months or less if the illness runs its normal course.
In 2000, the Alzheimer’s Association Ethics Advisory Panel agreed that Alzheimer’s disease, in its advanced stage, should be defined as a terminal disease.
What are the signs of advanced stage Alzheimer's? Basically, the indicators are the inability to:
- recognize loved ones
- communicate by speech
- ambulate, or
- maintain bowel or bladder control
When these indicators are exhibited regularly, death can be expected within a year or two, regardless of medical efforts. Given typical medical problems arising at this time, the Panel noted that efforts extending life during this stage created "burdens and avoidable suffering for patients who could otherwise live out the remainder of their lives in greater comfort and peace".
So, what does this mean to you as the caregiver? Hospice is usually only available to those with six months or less to live. Alzheimer's patients at the "end stage" can realistically expect to live another one to two years. Yet, during that time, they decline dramatically, may be in extensive pain, and are no longer able to communicate. If after learning about the hospice philosophy you decide that it is right for your family member and your family member has reached the end stage of Alzheimer's, talk to your doctor. As more people bring this issue to light and ask for help, the more likely it will be that help will become available. Also talk to your local Alzheimer's Association. They will be the most up-to-date on any changes that would offer you some relief and assistance at this stage of the disease. For more information, read the information offered below.
End of Life: Helping With Comfort and Care
Ethical Issues Relating to End of Life Care for Alzheimer's
Find My Alzheimer's Association Chapter
Honoring the Wishes of the Person with Alzheimer's
Mayo Clinic on End of Life Care With Comfort and Dignity
Medicare's Hospice Benefit for Alzheimer's Beneficiaries