Hospice Dementia Pathways Program
Embarking on the intricate journey of dementia care can present both practical and emotional hurdles. At Honor Hospice, we understand that as dementia progresses, the need for specialized support becomes increasingly important.
Our dedicated team is thoughtfully designed to provide guidance and support to individuals and their families when the shift to hospice care becomes necessary. As dementia progresses, patients and their loved ones face a multitude of unique challenges, encompassing not only physical but also emotional, spiritual, and psychosocial aspects. Our tailored care approach is geared toward addressing these complexities and offering unwavering support every step of the way.
Challenges of Dementia
Physical Challenges with Dementia
Dementia introduces a range of physical challenges for individuals living with the condition. These challenges often encompass difficulties with mobility, as dementia can impair balance and coordination, leading to an increased risk of falls. Nutrition and hydration can become problematic, with individuals forgetting to eat or drink, potentially resulting in malnutrition and dehydration. Issues related to incontinence and weight loss may also emerge. Additionally, restlessness and agitation are common, causing physical fatigue. Sleep disturbances disrupt regular rest patterns, contributing to physical exhaustion. Immobility can lead to skin problems, including pressure sores, and difficulties with oral hygiene may affect dental health.
The coexistence of dementia with other chronic medical conditions requires specialized management. Addressing these physical challenges necessitates a comprehensive approach, involving proper nutrition, hydration, mobility support, and regular medical assessments, with caregivers and healthcare professionals playing a vital role in ensuring the overall well-being of individuals living with dementia.
Emotional and Psychosocial Challenges with Dementia
Living with dementia presents individuals and their families with a multitude of emotional and psychosocial challenges. Coping with the progressive loss of cognitive abilities can evoke feelings of frustration, anxiety, and sadness. Memory lapses and difficulty recognizing loved ones can be emotionally distressing, leading to a sense of isolation and grief.
Dementia often alters personality and behavior, resulting in mood swings, agitation, and even aggression. This can strain relationships and make caregiving emotionally demanding. Caregivers themselves may experience stress, burnout, and a sense of helplessness as they witness their loved ones’ decline.
Individuals with dementia may also grapple with a loss of identity and independence, leading to feelings of worthlessness and depression. Social isolation can further exacerbate these challenges, as individuals may withdraw from social activities due to embarrassment or fear of judgment.
Spiritual Challenges with Dementia
Dementia can introduce spiritual challenges for individuals and their families. As memory and cognitive functions decline, individuals may grapple with questions of identity, purpose, and the meaning of their journey. Coping with the loss of cherished memories and abilities can prompt a profound sense of loss and existential questioning. For caregivers and family members witnessing a loved one’s spiritual struggle can be emotionally challenging. Addressing these spiritual challenges often involves providing a supportive and compassionate environment, encouraging spiritual practices that bring comfort, and fostering a sense of connection and meaning throughout the dementia journey.
How the Hospice Dementia Pathways Program Can Help
The Hospice Dementia Pathways Program offers support to individuals coping with dementia along with their caregivers during difficult times. Our expert team at Honor Hospice is dedicated to providing compassionate care and addressing the unique challenges that face both those with dementia along with their family and caregivers. We specialize in managing symptoms and ensuring comfort, making sure that the journey through dementia is as smooth and supportive as possible.
The Hospice Dementia Pathways Program includes:
Pain & Symptom Management
Our interdisciplinary team creates a specialized care plan to manage common symptoms experienced by those with dementia which may include increased confusion & cognitive decline, sleep distrubances, agitation, anxiety, weakness & fatigue, pain, difficulty swallowing, and decreased nutrition.
Our team utilizes a gentle, individualized approach understanding that each individual with dementia is unique. We work to create a plan together with the patient and caregivers to ensure our approach fits the identified needs.
Skilled Nursing Care
Hospice care includes skilled nursing services provided by specially-trained hospice nurses who have expertise in managing the complexities of Alzheimer’s disease and dementia. These skilled nurses assess and monitor the patient’s condition, provide anticipatory guidance based on disease progression, educate the patient and caregivers, manage medications, provide wound care if needed, and collaborate with other healthcare professionals to ensure comprehensive care.
Personal Assistance & Assistance with Activities of Daily Living (ADLs)
Nurse aides, also known as certified nursing assistants (CNAs), are an integral part of the hospice team. They provide hands-on assistance with activities of daily living (ADLs), such as bathing, dressing, grooming, and toileting. For individuals with dementia and Alzheimer’s disease who may experience fatigue and physical limitations due to disease progression, nurse aides help maintain personal hygiene, promote comfort, and preserve dignity.
Emotional & Psychosocial Support
Hospice care extends support not only to patients but also to their families and caregivers. Helping a loved one with dementia can be challenging. Social workers and counselors are available to provide emotional support, counseling, and resources to cope with the challenges that arise during this difficult time. The nursing team is available to assist in educating and guiding you through providing the best care to your loved one with dementia.
Spiritual & Emotional Support
Hospice care acknowledges the importance of spiritual and emotional well-being during end-of-life care. Chaplains or spiritual counselors are available to provide spiritual support, and bereavement services are offered to help families cope with grief and loss after the passing of a loved one. Our chaplains can coordinate visits and calls from a patient’s local clergy as well.
Medication Coverage
Hospice fully covers medications related to the terminal illness to assist in providing peace and comfort. This ensures that patients have access to the resources they need to maintain comfort and improve their quality of life.
Supplies for Daily Care
Hospice provides disposable supplies including items like adult briefs, incontinence pads, personal hygiene wipes, gloves, wound care supplies, thickening agents for drinking liquids, and mouth moisturizers.
Medical Equipment
All durable medical equipment related to the terminal condition is fully covered under the hospice benefit. With heart conditions, this may include a wide range of supplies including items like wheelchairs or other mobility aides, shower chairs, fully electric beds, or additional items determined to be necessary by agreement of the hospice team, patient, and caregivers.
24/7 Availability
Hospice care offers round-the-clock access to the hospice team, providing peace of mind for patients and their families. This availability ensures that assistance is available whenever it is needed, even outside regular office hours.
The main focus of the Hospice Dementia Pathways Program is to provide personalized support that meets the needs of both the patient and their caregivers. We understand the unique challenges faced by those with heart disease. Our commitment lies in creating a compassionate and nurturing atmosphere where individuals can preserve their dignity and receive the comfort they deserve. Using evidence-based practices, our team works to address the physical, emotional, mental, and spiritual needs of those we serve.
Hospice Eligibility Guidelines forDementia & Alzheimer's Disease
Hospice Eligibility Guidelines for Individuals with Dementia & Alzheimer’s
We understand that navigating the complexities of hospice care can be overwhelming, especially when dealing with dementia. This page aims to provide you with a comprehensive guide to the eligibility guidelines for hospice care specifically designed for individuals facing dementia.
Dementia diagnoses may include:
- Alzheimer’s Disease
- Dementia with Lewy Bodies (DLB)
- Vascular Dementia
- Parkinson’s Disease Dementia
- Huntington’s Disease
- Other Dementia Forms
Disease Specific Guidelines
Patients who meet the following criteria will be deemed to be in the terminal stage of dementia, with a life expectancy of six months or less if the illness runs its course. These criteria apply to patients with different forms of advanced dementia who ultimately follow a final common pathway for end-stage disease. The patient should show all of the following characteristics:
- Stage seven or beyond according to the Functional Assessment Staging Scale
- Inability to ambulate (move/walk) without assistance
- Inability to bathe without assistance
- Inability to dress without assistance
- Fecal and urinary incontinence, constant or intermittent
- Lack of consistently meaningful verbal communication (speech limited to six or fewer intelligible words or only stereotypical phrases.
Patients should also have had one of the following in the preceding twelve months:
- Inability to maintain sufficient nutrition and hydration with 10% weight loss during the previous six months or a serum albumin <5gmdl
- Aspiration pneumonia
- Pyelonephritis or other upper urinary tract infection
- Septicemia
- Decubitus ulcers (pressure injuries), multiple, stag 3-4
- Fever, recurrent following antibiotics
Non-Disease Specific Guidelines
- Physiologic impairment of functional status demonstrated by a score < 70% using either:
- Karnofsky Performance Status (KPS)
- Palliative Performance Score (PPS)
- Dependence on assistance for two or more of the following activities of daily living (ADLs):
- Feeding
- Bathing
- Dressing
- Toileting
- Ambulation (walking/moving)
- Transfer
Co-morbidities
Although not the primary hospice diagnosis, the presence of certain co-morbidities should be considered in determining hospice eligibility, as the severity of these conditions is likely to contribute to a life expectancy of six months or less. These co-morbidities may include:
- Chronic obstructive pulmonary disease
- Congestive heart failure
- Ischemic heart disease
- Dementia
- Renal failure
- Diabetes mellitus
- Liver disease
- Acquired immune deficiency syndrome (AIDS)
- Neurologic disease (CVA, ALS, MS, Parkinson’s)
- Neoplasia
Disclaimer: Please note that the information provided on this page is intended for general guidance purposes only and should not replace professional medical advice. Each individual’s situation is unique, and eligibility for hospice care should be assessed by qualified healthcare professionals.
Speak to the Our Team
If you or someone you know want to learn more about the hospice care, eligibility for hospice, or our Hospice Dementia Pathways Program, please contact us today or refer yourself or a loved one to our care. Our compassionate team at Honor Hospice is dedicated to providing information, support, and personalized care during this challenging time.