Guidelines for Admission/Recertification of a Person with Alzheimer’s Disease and Related Disorders to Hospice Care.
This summary is intended to give families and caregivers of persons with dementia a general idea about criteria for admission to Hospice care. If you feel your loved one qualifies for admission to a Hospice program, you must contact the person with dementia’s personal physician, who will need to write a referral for Hospice services. In addition, please be aware that there are two types of Hospices, 1) not-for-profit, and 2) for profit. This means that they may have different interpretations of these guidelines.
Hospice’s admission guidelines for persons with dementia of either Alzheimer’s or multi-infarct type (irreversible) are as follows:
- Person has to be in the end-stages of the disease, (stage 7 or beyond).
- Person cannot walk, dress, or bathe properly without assistance.
- Person is incontinent.
- Person has little or no meaningful verbal communication.
- Presence of medical complications that require hospitalization. Must have had one of the following in the past 12-months: aspiration pneumonia, kidney infection, septicemia, multiple ulcers, and recurrent fevers after antibiotics.
- Deteriorating nutritional status as evidenced by difficulty swallowing or refusal to eat and progressive weight loss, etc.
- The person exhibits severe cognitive impairment as evidenced by progressive confusion, anger, frustration or withdrawal, inability to recognize family or friends, loss of ability to follow directions, loss of immediate and recent memory with progressive loss of remote memory.
- The patient/family desires no further medical intervention and/or aggressive medical intervention is considered futile.
- There are other existing medical problems accelerating terminal disease such as CHD, COPD, Renal disease, Liver disease, etc.
Guidelines 1 and either 2 or 3 must be present and clinical judgment must always be considered!
Also, if a person with dementia admitted to Hospice care shows significant
improvement to the point the person is discharged from Hospice, the person can
be referred again for Hospice care and be admitted regardless of a previous