Hospice consult needed if patient for dementia:

if Dementia patient:(end-stage memory disorders)

Can say only a few words

Are dependent on others for all activities of daily living (toileting, feeding, dressing)

Are no longer ambulatory

Have been through s lengthy period of decline lasting several years

Hospice admission guidelines for end-stage Alzehermer's and other forms of dementia

Main symptoms of advabced dementia present in FAST 7:

inability to ambulate without assistance

inavility to speak or communicate clearly (often with vocabulary limited to one to five words per day)

Other symptomsof advanced dementia present in FAST 6:

Incontinence of bowl and bladder

Inability to dress without assistance

Inability to bathe without assistance

Intercurrent illeness associated with advanced dementia:

Aspitation pnemonia

Pyelonephritis or upper urinary tract infection

Septicemia 

Decubitus ulers, multiple, stage 3-4

Fever recurrent after antibiotics

Impaired nutritional status:

Difficulty swallowing or refusal to eat

If patient is receiving artificial nutritional support (NG ot G-tube, TPN), patient must be exhibiting continued weight loss despite the feeding

Comobid conditions that significantly impair the dementia patient's health and functionality:

CHF or cardiovascular disease

COPD or restrictive lung disease

Cerebrovascular disease, including stroke

DM

Renal insufficiency

Malignancy

P.S.

Alzheimer's disease, which accounts for more than 50 percent of all dementia cases, geneally progresss in a linear fashion over an average of seven to ten years, but may be much longer in some instances. A person transitions through several stages of deterioation, which roughly parallel the stage of infant and childhood development in reverse. the essential skills acqired in the first month of life are eventually lost. These include the ability to respond or speak coherently, to walk and sit up, to control the bowls and bladder; even swallowing becomes impaired.


From VITAS, Innovative Hospice Care