What is Alzheimer’s hospice?
Alzheimer’s hospice is a medical care for patients who are suffering from Alzheimer’s or other forms of dementia such as vascular dementia, Lewy body dementia, and Frontotemporal dementia. Patients with Alzheimer’s and other forms of dementia can experience increased levels of comfort and dignity at the end of life through hospice care.
Hospice care through the hospice care teams can help in identifying when a patient suffering from Alzheimer’s or other forms of dementia is in the final days of life. The signs of the final days of Alzheimer’s or other forms of dementia are being unable to move around on one’s own, being unable to speak or make oneself understood, and having difficulty in swallowing or other eating problems. These signs, which are identified by the National Institute of Aging (NIA), can help in predicting the number of days left of a person with end-stage Alzheimer’s disease or other forms of dementia.
Does Alzheimer’s qualify for hospice?
Yes, Alzheimer’s qualify for hospice. Hospice care for people with Alzheimer’s and other forms of dementia is necessary because of the special challenges the caregivers of patients with Alzheimer’s face, according to the NIA. The NIA, under the National Institutes of Health, states that the special challenges are due to the disease progression of Alzheimer’s being unpredictable.
On the other hand, patients with Alzheimer’s or people with dementia may look physically healthy. The NIA points out that Alzheimer’s and other forms of dementia cripple a patient’s thinking, remembering, and reasoning abilities. These effects can hinder patients from making health care decisions for themselves at the end of life.
What are the types of Hospice Care for Alzheimer’s Patients?
There are four types of hospice care for Alzheimer’s patients. The first type is routine home care. Routine home care focuses on controlling the symptoms of Alzheimer’s and other forms of dementia through activities like regular walks, calming music, supervised meals, and eyes and ears checkups. These activities can be provided in the patient’s home.
Another type of hospice care for Alzheimer’s patients is general inpatient care. General inpatient care can help patients who have reduced levels of independent functioning and may require extended hospital admission. It can also improve the patient’s care and treatment and also access to a full range of post-diagnostic support and interventions, according to the National Institute for Health and Care Excellence (NICE).
The next type of hospice care is continuous home care. Continuous home care or crisis care allows patients with Alzheimer’s and people with dementia to live comfortably at the end of life in their homes. Their needs and support will be provided by trained hospice care professionals. These trained medical professionals can communicate with the patient’s family members about what they are experiencing and what they need.
Another type of hospice care for Alzheimer’s patients is respite care. Respite care is provided in a nursing home, a hospice inpatient facility, or a hospital when the primary caregiver, such as a family caregiver, needs some time off. Primary caregivers need time off so they can recuperate or attend to some of their needs while the patient is receiving assistance from hospice care or palliative care professionals.
What are the Benefits of Hospice Care for Alzheimer’s Patients?
There are several benefits of hospice care for Alzheimer’s patients under Medicare. The services Alzheimer’s patients can receive from hospice care providers are the following:
- Doctor services
- Nursing care
- Medical equipment such as wheelchairs or walkers
- Medical supplies such as bandages and catheters
- Physical and occupational therapy
- Speech-language pathology services
- Medical social services
- Dietary counseling
- Hospice aide
- Grief and loss counseling services
- Short-term inpatient care for pain and symptom management
- Short-term respite care
- Prescription drugs for symptom control or pain relief
Aside from these medical services, patients with Alzheimer’s can get free hospice services, a 95% discount for inpatient respite care, and up to $5 for each prescription drug for symptom relief or pain control from Medicare.
When should an Alzheimer’s patient be put on hospice?
An Alzheimer’s patient should be put on hospice if the patient has six months or less to live or is in the terminal stage. Under Medicare, hospice doctors can determine if the Alzheimer’s patient should be put on hospice.
Hospice care for Alzheimer’s patients can also be determined by the presence of co-morbid diseases such as chronic obstructive pulmonary disease (COPD), congestive heart failure (CHF), cancer, liver disease, renal failure, and neurological disease.
Hospice program for Alzheimer’s patients can also be decided by having one of the following secondary conditions such as delirium, recurrent or intractable infections, pyelonephritis or other urinary tract infection (UTI), septicemia, decubitus ulcers, fevers after antibiotics, aspiration pneumonia, and inability to maintain sufficient fluid and calorie intake.
What are the Medicare Alzheimer’s hospice criteria?
The Medicare Alzheimer’s hospice criteria require having a Medicare Part A. Medical Part A or hospital insurance includes inpatient hospital stays, skilled nursing facility care, hospice care or end-of-life care, and home health care.
Aside from Medicare Part A, the patient with Alzheimer’s or other forms of late-stage dementia must meet all the conditions. The first condition is that the hospice doctor and medical doctor must certify that the patient is terminally ill. A terminally ill patient has a life expectancy of 6 months or less.
The next condition is that the patient must accept comfort care or palliative care instead of treatment for Alzheimer’s and other forms of dementia. Patients with Alzheimer’s or dementia patients must also sign a statement choosing hospice care or palliative care over other Medicare-covered treatments.
What are the LCD guidelines for Alzheimer’s hospice?
The Local Coverage Determination (LCD) guidelines for Alzheimer’s hospice support a prognosis of 6 months or less under different clinical scenarios. The prognosis can be supported by identifying some structural or functional impairments and relevant activity limitations. These factors can serve as the basis for palliative interventions and care planning, according to the Centers for Medicare and Medicaid Services (CMS). The CMS, under the Department of Health and Human Services (HHS), administers the Medicare program and Medicaid with state governments.
The LCD guidelines require patients with Alzheimer’s disease and another form of dementia to have a Functional Assessment Staging (FAST) greater than or equal to Stage 7. Stage 7 identifies the level of activity limitation that supports six months or less prognosis.
FAST Stage 7 is the loss of speech, locomotion, and consciousness. The sub-stages of FAST Stage 7 are the following:
- Ability to speak limited such as 1 to 5 words a day
- All intelligible vocabulary lost
- Unable to sit up independently
- Unable to smile
- Unable to hold head up
How long can Alzheimer’s patients be in hospice?
Alzheimer’s patients can be in hospice for two 90-day benefit plan periods under Medicare. Medicare also allows unlimited 60-day benefit periods after the two 90-day periods. Each period requires a hospice doctor to recertify that the person remains qualified to receive hospice services.
Receiving hospice services can be terminated by the Alzheimer’s patient. The Alzheimer’s patient can immediately start to receive other Medicare benefits as soon as hospice service stops.
What does hospice do for an Alzheimer’s patient?
Hospice care is aimed at managing pain and other symptoms brought on by Alzheimer’s and other forms of advanced dementia in the last six months of the life of the patient. The last six months of the life of the patient are focused on bringing comfort, quality of life, and dignity through hospice care and also preparing their families for the inevitable death.
Hospice care or end-of-life care is provided by a hospice team. A hospice team consists of hospice providers such as doctors, nurses, home health aides, social workers, counselors, clergy, and other volunteers. They offer an individualized care plan for patients with Dementia and Alzheimer’s disease.
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