Vascular dementia in hospice refers to providing specialized end-of-life care and support for patients with advanced stages of vascular dementia and a limited life expectancy, typically less than six months. Vascular dementia is one of the most prevalent forms of dementia. It is frequently accompanied by a decline in cognitive function due to decreased blood flow to the brain, typically caused by strokes or other vascular-related conditions.
When a patient with vascular dementia enters hospice care, the healthcare team has determined that curative treatments are no longer beneficial or appropriate, and the focus shifts to providing comfort, managing symptoms, and enhancing the patient’s quality of life during their final days.
In the US, there are almost 15 million unpaid family carers for Alzheimer’s and dementia patients, with at least 5 million Americans affected by Alzheimer’s disease and associated dementias. Initial symptoms of Alzheimer’s disease include memory lapses, such as being unable to find items or discover the right word or name. Although they can operate independently, patients may struggle to organize. People with moderate to intermediate conditions require more attention, as Alzheimer’s patient’s memory loss and confusion worsen at this stage. They may forget their names or where they are, requiring help remembering to dress for the weather. This stage usually lasts the longest, years, and can modify personality and sleep patterns.
Individuals in the last stages of dementia require support with activities of daily life around the clock. They become less conscious of recent events and their surroundings and may have an increasingly difficult time communicating. Alzheimer’s patients in the later stages of the disease are more likely to get infections, particularly pneumonia. During the final stages of dementia, carers must anticipate the requirements of their loved one, as they may even forget how to swallow or take a drink through a straw.
Families often do not know when their loved one with Alzheimer’s disease or another form of dementia will become eligible for hospice care. This is because the advancement of Alzheimer’s disease and other dementias tends to be slow, and there is no predetermined minimum or maximum number of symptoms that a patient must display to qualify for hospice treatment. To ascertain whether a loved one is displaying any of the often-observed symptoms, please evaluate the following list and establish the next course of action.
When will your dementia patient be ready for hospice care? Patients diagnosed with dementia or Alzheimer’s disease are considered candidates for hospice care when all of the following factors are present:
- Incapable of walking without the aid of a carer
- Incapable of dressing oneself without assistance
- Incapable of taking adequate showers
- Incontinence of bowel and bladder Unable to speak or communicate meaningfully (capacity to speak is limited to around a half dozen or fewer coherent and different words)
When healthcare workers consider dementia to be a fatal illness, rather than a condition that would only worsen over a few months, they can concentrate their efforts specifically and aggressively on developing a palliative care plan for their patients.
Examples of concurrent disorders related to advanced dementia include pneumonia caused by aspiration, pyelonephritis, acute septicemia, ulcers of decubitus, numerous stages 3-4, and fever that comes back after taking antibiotics. Patients with inadequate nutritional status, swallowing difficulties, or a complete reluctance to eat may require artificial nutritional support. Malnutrition due to a lack of protein and calories can be indicated by weight loss of over 11%, BMI<18, or Albumin <3.1. Co-morbid conditions that significantly impair the dementia patient’s health and functionality include congestive heart disease, cardiovascular disease, COPD or restrictive lung disease, cerebrovascular disease, including stroke, diabetes mellitus, renal insufficiency, and malignancy.
It can be hard for family members to determine if a patient needs hospice care since Alzheimer’s and other dementias progress slowly. Hospice care should be discussed immediately to be ready if hospice dementia eligibility standards are met. Melodia hospice care can evaluate a dementia patient in their home, hospital, or assisted living facility to see if they qualify for hospice care. We will meet families at their convenience without hesitation.