The word hospice conjures up different images for different people. To those of us who dedicate our lives to its work, we see a philosophy of care that puts the patient and his support system at the center and involves a team of individuals who have the patient goals driving their plan of care.
For whatever reasons, hospice care has been associates with cancer patients but hospice is not limited by diagnosis and never has been. The only requirements for hospice care is consent to care by the patient and an estimated prognosis of six months or less by two physicians.
When it comes to dementia, a six month time frame becomes very difficult to estimate. Many patients with dementia have other chronic illnesses where others are quite healthy other than their dementing illness.
Over the last few years, guidelines have been established so that physicians and hospices can make a better decision when it comes to deciding whether or not a patient with dementia “qualifies” for hospice.
Why is this important? Because hospice care can have such a profound impact on the patient and, even more importantly, on the family. The hospice team consists of a number of individuals involved either directly or indirectly with the patient and his family. Nurse, physician, social worker, pharmacist, home health aide, volunteer, spiritual care, dietician, therapists- any or all of these people may by involved at some point during the patient’s stay on hospice. As a team, their goal is to manage symptoms, provide comfort, assist with coping, and ultimately, meet the needs of the patient and family. Bereavement services are also provided to the family for thirteen months following the patient’s death.
Persons being considered for hospice care must meet eligibility guidelines determined by Medicare. These guidelines, called LMRP’s (Local Medical Review Policy), take into account severity of disease and degree of impairment, and attempt to preserve hospice benefits for those who truly are in the final months or weeks of life.
Hospice Eligibility Criteria:
To be enrolled in hospice, ALL of these signs and symptoms must be present:
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