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Published March 01, 2014, 10:30 PM

Minding Our Elders: Hospice offers quality end-of-life care for Alzheimer’s

DEAR CAROL: My dad has been in a local nursing home for several years. He has many health issues but advanced Alzheimer’s is his biggest problem.

By: Carol Bradley Bursack, INFORUM

DEAR CAROL: My dad has been in a local nursing home for several years. He has many health issues but advanced Alzheimer’s is his biggest problem. He cries out sometimes and seems to be in pain, but the doctor says they are doing all that they can. The doctor says that Alzheimer’s is a terminal disease and they can only do so much. I hear great things about hospice care for the end of life, but can hospice help keep people with Alzheimer’s comfortable? When can we ask hospice for care? Is it better to leave Dad in the nursing home for hospice care or bring him to our house? Does Medicare pay for hospice? Thanks for any help you can give us. – Jeff

DEAR JEFF: A doctor must determine that a person has six months or less to live in order for the patient to be enrolled in hospice care. Therefore, your first step is to talk with your dad’s doctor and see if he qualifies. From what you said he probably will.

Your next step is to choose a local hospice organization. My community has only one hospice provider, but it’s a wonderful nonprofit so we are blessed. If you have more than one hospice organization, go by word-of-mouth praise and/or ask for references. Hospice provides care for many people with end-stage dementia so I wouldn’t worry about them knowing how to help your dad. You can, of course, inquire about their experience just for peace of mind.

Both of my parents had quality hospice care while staying in the nursing home that they had lived in for several years. It was a wonderful experience to see each of my parents more able to communicate once they could stop concentrating on pain. Even when their illnesses left them no energy to communicate, no pain was evident. When their time came, they passed peacefully.

You could take your dad to your home for care but since he’s been in the nursing home for many years this facility is now home to him. Personally, I wouldn’t put him through the move. You can spend as much time with him as you want at the nursing home yet know that he is well cared for when you must leave him.

Most insurance companies, including Medicare, pay for hospice so payment shouldn’t be a problem. Hospice personnel will guide you with the paperwork.

Once hospice takes over your dad’s care, they will work seamlessly with the nursing home staff. Your dad will have familiar people caring for him, but he’ll have additional people from hospice as well. Pastoral care for the family is available if you choose. In my experience, hospice personnel have been wonderful about explaining the care that they are providing and why they do what they do.

I’m sorry that your family must go through this decision making process, Jeff, but once you see your dad being lovingly cared for and pain free you’ll likely feel very confident that you made the right choice. Always feel free to ask questions. Your hospice caregivers should be happy to help in any way.

Carol Bradley Bursack is the author of a support book on caregiving and runs a website supporting caregivers at www.mindingourelders.com. She can be reached at carolbursack@msn.com.

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