When a senior and his or her family are facing end-of-life care decisions, there are many considerations that come into play. Much of the decision-making will fall on the family, especially in the case of elders who are unable to make their own decisions because of the advancement of their illness, such as Alzheimer’s or other forms of dementia. These decisions in San Francisco and elsewhere are not easy, but they have to be made.

June was Alzheimer’s and Brain Awareness Month, and it’s important to shed light on these issues that plague 55 million people suffering from

  • Frequently visits the ER
  • Is showing a decline in how well (if at all) they can perform daily tasks, such as dressing, walking, eating, or using the bathroom
  • Is falling more often
  • Has shown changes in mental abilities
  • Is experiencing progressive weight loss
  • Has skin tears and infections

Here is a look at the criteria that is used in determining hospice eligibility.

Lack of improvement: This is when, even with treatment, the patient’s condition is no longer improving. They are not feeling any better and their illness has advanced to end-stage disease.

Care goals have changed: This is when the patient understands the situation is not going to get better and has decided not to be in the hospital anymore. This is often when the patient and family members have accepted the reality and are ready to take the next step beyond treatment of the disease into comfort measures.

Acute health events: End-of-life care may be required when the patient suffers from an acute event, such as a stroke or heart attack, that leaves no choice regarding entry into hospice.

Once a patient has been referred to hospice by a doctor, a hospice nurse will visit with the patient and family to conduct a health assessment. Your loved one may qualify for hospice if they are showing these common signs:

  • Weight loss of 10 percent in past three to six months
  • Insufficient hydration and nutrition
  • Difficulty swallowing
  • Shortness of breath
  • Inability to perform daily activities independently
  • Spends most days in a chair or in bed
  • Increased daytime sleeping and fatigue
  • Worsening incontinence
  • Pain or emotional suffering
  • Recurrent/multiple infections
  • Increased cognitive impairment, unintelligible speech, confusion
  • Increased visits to the ER
  • Rapid disease progression regardless of treatment