Hospice Care for Persons With Dementia

Do You Know That Hospice Care is Available for Dementia Patients?

Hospice is a program that offers specialized care for end-of-life situations.  Most people think of Hospice in connection with cancer, but Hospice care is available for people of all ages with many terminal diagnoses including Alzheimer’s disease and other related dementias when the patient meets the established criteria for Hospice care.  Hospice programs operate in the home, in assisted livings, in nursing homes and/or in established in-patient Hospice residential facilities.

Both of my parents were hospice patients at the end of their lives.  My father died at home with Hospice care after a very short bout with an aggressive cancer; mom died in a  nursing home with complications secondary to Alzheimer’s disease.  Mom met the Hospice criteria because of significant weight loss.

The criteria for Hospice Appropriateness : END STAGE DEMENTIA

* Patients with dementia must show all of the following characteristics:

1.  Stage seven (7) or beyond according to the Functional Assessment Staging Scale (FAST.)

2.  Unable to ambulate without assistance.

3.  Unable to dress without assistance.

4.  Unable to bath without assistance.

5.  Urinary and fecal incontinence, intermittent or consistent.

6.  No meaningful verbal communication, stereotypical phrases only, or ability to speak is limited to six (6) or fewer intelligible words.

7.  Patients must have had one of the following within the past 12 months:

*  Aspiration pneumonia

*  Pyelonephritis or other upper urinary tract infection

*  Septicemnia

*  Decubitus ulcers, multiple, stages 3-4

*  Fever, recurrent after antibiotics

*  Inability to maintain sufficient fluid and caloric intake with 10% weight loss during the previous six months or serum albumin greater than 2.5 gm/dl.

If you think your loved one is eligible for Hospice care you may request an order for care from your physician, or call a local Hospice for an assessment.  Most people make the mistake of waiting too long to call.  To make the best use of Hospice services call as soon as you think it may be appropriate.

In Minnesota, you can learn more about Hospice care by contacting Hospice of the Twin Cities, 763-531-2424.  Their website is:  http://www.hospiceofthetwincities.com

What Does “Failure to Thrive Mean?”

Minnesota Social Worker Talks About FTTOA

Yesterday I attended a small networking meeting where Intrepid USA Social Worker, Susan Long, talked about this prevalent diagnosis among seniors.  Failure to Thrive in Older Adults is sometimes used as a diagnosis to admit a patient to the hospital.  Part of treatment is often the administration of IV fluids for dehydration. 

The speaker’s emphasis was on the importance of recognizing this condition in our parents and older friends early enough so that available resources can be called in to help reverse the condition.

In order to meet the criteria for the diagnosis, all four of the following must be present:

     1.  Decline in physical function

     2.  Rapid weight loss with poor appetite

     3.  Depression or social withdrawal

     4.  Impaired cognitive or mental functioning.

It is estimated that 1/3 of nursing home residents suffer from FTTOA.  As many as 35% of elders residing in the community and more than 50% of hospitalized veterans may be failing to thrive. Those age 85 and older are most at risk.  

Professionals beneficial in the diagnosis and treatment of FTTOA include (but are not limited to:)  physicians, nurses, physical, occupational and speech therapists, social workers, dieticians, and dentists.

Home care offers help in many ways–valuable observers, social contacts, help with meals, help getting out in the community for enjoyable activities.

Seniors’ Choice at Home offers dependable care givers in the Twin Cities (Minnesota) to help seniors thrive, and not just survive.  Check our our website at www.seniorschoicemn.com or call Marilyn at 763-546-1599