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Hospice and Palliative Care for Dementia Patients

Given the long progression of Alzheimer’s disease and other forms of dementia, in home caregivers may not know when to transition their loved one to palliative and hospice care.

“A high-quality hospice will provide the dying patient with desired symptom control, emotional support, treat the dying patient and family with respect, provide the needed skills and knowledge in caring for the patient, and provide emotional support before and after the patient death,” said Dr. Joan Teno, MD, M.S. Dr. Teno is Professor of Health Services, Policy, and Practice at the Warren Alpert School of Medicine at Brown University.

In a study published in August in the Journal of American Geriatrics Society, Dr. Teno and other experts concluded that, “Bereaved family members of people with dementia who received hospice reported higher perceptions of the quality of care and quality of dying.” The study focused on nursing home patients, where the majority of people with dementia go in the final stages of the disease.

In a 2009 New England Journal of Medicine article, Dr. Teno was part of a group that looked at when to consider hospice care for those with dementia.

For people with advanced dementia patient—those who cannot walk or have difficulty communicating their needs—she offered the following criteria:

  • Development of pneumonia or febrile illness is a trigger to consider the goals of care and consider of hospice.

  • Development of eating problems -- choking on food, unable to eat enough to maintain their weight is a trigger for hospice care.

“Hospice provides a holistic care for persons with dementia with focus on patient and family-centered care,” Dr. Teno said.