Feasible Criteria for Enrolling End-Stage Dementia Patients in Home Hospice Care

Hospice care is considered appropriate for end-stage dementia patients (Luchins & Hanrahan, 1993 Luchins, DJ, & Hanrahan, P. (1993). What is appropriate health care for end-stage dementia? J of Amer Geriatrics Society. 41: 25–30. [Google Scholar]), yet less than 1 percent of hospice patients have a primary diagnosis of dementia (Hanrahan & Luchins, 1995 Hanrahan, P., & Luchins, DJ. (1995). Access to hospice care for end-stage dementia patients: A national survey of hospice programs. J of Amer Geriatrics Society. 43:56–59.[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]). This pilot study tested the feasibility of providing palliative care for dementia patients. A common eligibility requirement for admission to hospice is that the patient is likely to die within six to seven months. The uncertain survival time of dementia patients thus prevents access to hospice programs. Therefore, enrollment criteria were developed based on the characteristics of advanced dementia and a history of medical complications. With these criteria established, it was then possible to enroll 11 patients over two years. The enrollment criteria proved successful in that the median survival time was five months, with an average of seven months. Eight of the 11 patients died during the study. Hospice care was well accepted by family caregivers and appeared to meet the patient’s needs. [Single or multiple copies of this article are available from The Haworth Document Delivery Service: 1-800-342-9678, 9:00 a.m. - 5:00 p.m. (EST).]