August 3, 2010
Hospice is a round-the-clock care service for people who are terminally ill. The goal of hospice is to keep the person with Alzheimer’s as comfortable as possible in the final stages of disease and enable the person to spend precious time with family and friends.
A team of professionals, which may include a medical director, the person’s attending physician, nurses, social workers, counselors, clergy and home health aides provides hospice care. In order to ensure the best care possible, the team typically meets regularly to evaluate and coordinate the plans of care. A member of the team should be available 24 hours a day to address questions, concerns and problems. Hospice care may be provided in the person’s home, in a nursing home, or assisted-living facility, or wherever the person resides.
At what point is hospice care warranted?
Hospice services only accept individuals who are terminally ill. The acceptance criteria for a person with Alzheimer’s disease are as follows:
- The person must be diagnosed by a licensed physician as having end-stage Alzheimer’s disease (or similar end-stage dementia) with limited life expectancy (six months or less).
- The person with Alzheimer’s must live within a specified geographic boundary of the individual hospice service.
- The family of the person with Alzheimer’s must consent to hospice services. The family must provide a healthcare proxy or living will (depending on what your state requires) that is signed by the person with Alzheimer’s. If no proxy or living will is available, the family must provide clear, convincing evidence that the wishes of the person with Alzheimer’s are known regarding extraordinary treatment such as resuscitation or tube feeding (when the person is no longer able to eat solid food and nourishment is provided through a tube in the person’s esophagus).
What questions should I ask when considering a hospice provider?
1. Do you have a 24-hour contact person in case of emergencies? If so, how long does it take them to respond?
2. Do you have staff trained specifically in Alzheimer’s disease?
3. Do you develop a plan of care? If so, is the family involved with the development? How often is it updated?
4. How do you conduct the preliminary evaluation and who is involved?
5. How many years has your agency been in business?
6. Is your agency accredited by a licensing organization such as the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO)? Is it licensed by the state?
7. Is your agency Medicare certified?
8. May I have references?
Where do I find hospice services?
The National Hospice and Palliative Care Organization has a national database of programs across the country.
How do I pay for hospice care?
Medicare, Medicaid and many private insurance policies cover hospice-care costs.