At What Point Will Hospice Provide Care for Someone With Alzheimer's?

2 answers | Last updated: Oct 16, 2016
A fellow caregiver asked...

At what point will hospice provide care for someone with Alzheimer's?

Expert Answers

Barbara Repa, a senior editor, is an attorney, a journalist specializing in aging issues, and the author of Your Rights in the Workplace (Nolo), now in its 10th edition.

Not all hospice providers use the same criteria for admission, but some standards are beginning to evolve. To be eligible for hospice care, the patient must generally be unable to:

  • Walk without assistance

  • Dress without help

  • Bathe or groom properly

  • Eat appropriately on his or her own

  • Control bowel or bladder

  • Speak or communicate meaningfully

In addition, the patient must be suffering from a severe related health issue, which may include:

  • Pneumonia

  • Signs of a recent stroke

  • Upper urinary tract infections

  • Open bedsores

  • Recurrent fever

  • Serious nutritional problems

But because hospice is typically reserved for people who have fewer than six months to live, Alzheimer's patients (who often have uncertain final time trajectories) or their caregivers have sometimes had to do some lobbying to get medical personnel to back their choice and hospice providers to provide the service.

However, new guidelines are helping by removing the onus from doctors who were uncomfortable making the prognosis that a person with Alzheimer's or related diseases has only six months or less to live.

The guidelines also give added weight and encouragement to Alzheimer's patients and their caregivers who find hospice care, with its goal of alleviating pain and discomfort, to be the most affordable care of choice. These guidelines were recently recognized by the government's Centers for Medicare and Medicaid Services -- an essential endorsement because Medicare pays for the lion's share of hospice services. Many hospice providers simply don't have the financial resources to care for those with Alzheimer's without Medicare coverage, and many patients can't afford it on their own. While many hospice providers claim they won't turn away anyone who can't afford to pay, strapped budgets sometimes make it impossible to keep this promise.

Finally, a patient with dementia often lives longer than the six-month limit some hospice providers establish. Should this happen, he or she can now be recertified for additional 30-day periods and continue receiving Medicare coverage.

For more information on Medicare coverage and hospice care, see the booklet published by the Centers for Medicare and Medicaid Services, Medicare Hospice Benefits.

Community Answers

Lola bell answered...

As you said no one now's for sure when someone is going to die, especially with alzheimer. I asked my moms doctor for options for some help with her care and next thing I knew hospice was calling me. Hospice explained to me that they have had people with alzheimer on and off of hospice care for up to three years. Every hospice is different, some are privately owned and some are state ran. They are not all good! The first hospice company that came to help out, was not so good. I had more care prier when mom was with visiting nurse association. The hospice nurse was to come to help me three times a week, but most of the time she would call to see how we were doing, but did not come but once every other week . They mailed me a lot of end of life drugs that had to go in my refrigerator and no personal directions of what to do with them. I believed mom needed more medical care then what they were giving me, not to mention I need some help for my self. I switched to a different hospice that was recommended to me by a friend.the second hospice company was wonderful and stayed with me to the end, and for a year after you can have there services with grief recovery.
Trust me they want your business. They get payed from Medicare for there work. Do make sure all charges are legitimate. We hope to have medicare for us one day.