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IS has mixed moderate dementia with signs of advancing dementia. DX is ALZ., Lewy Body and Capgras Syndrome.


Trying to be proactive in finding out what services may be needed down the road.


IS and I both are on Medicare and retired.

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This is a pretty good article:
https://www.nia.nih.gov/health/what-are-palliative-care-and-hospice-care

Hospice is a form of palliative care.
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My experience between the two was that if my husband would have went on palliative care(which he at the time qualified for)a nurse would have come to the house once a month to check on him and that was it. Well I was needing way more help than that so I said no thanks.
However when the time came for my husband to be under hospice care in our home, they sent a nurse out once a week to start, aides to bathe him twice a week, supplied all his needed equipment, supplies and medications all covered 100% under my husbands Medicare.
So there is a HUGE difference between the two, even though they both fall under the "hospice" umbrella. And you still have to qualify for both.
Wishing you the very best.
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wscare86 May 2022
WE considered Hospice for my dying brother who was in a Skilled Nursing Facility. Then I found out that Medicare would pay for Hospice but not the room and board in the SNF if he was under Hospice. The SNF provided the same care as Hospice as they would come in and tell the staff what to do. The SNF had their own Dr's. who did the same thing. We went with the SNF staff as the family did not need Hospice.
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Palliative care and Hospice care are well and thoroughly explained online if you use your search engine to type these headings.
Palliative care is a medical specialty that recognizes that an elder may not have a "cure" to what is ailing them. That the last years as approaching or are here. That an elder may wish to explore the options for "treatment" and may wish to refuse such things as dialysis, DNR, treatments that come at a large cost physically and mentally for little payback in health or quality of life. If you tell your Doctor that you would like a consult with a Palliative Care or Geriatric Care MD you can explore options with that MD.
Hospice care is something covered by Medicare when the end of life is CLEARLY here. When there is to be no longer treatments and trips to hospital for testing and treatment with any hope of cute. The end of life is expected within 6 months time in the opinion of treating MD. The MD can order hospice which has its own doctors, nurses, aids, clergy, social workers who work with and help family. The goal is comfort care, pain relief even if such relief is required in amounts of medication that may hasten death by some hours, days, weeks or months. Things that cause distress are treated toward comfort. Medicare allows hospice to reassess the patient at the end of the six months period. If it seems at that time that death is not nearing, that the patient is improving, hospice is not continued. All hospice care, including special hospital bed in home and etc. is covered by medicare.
Do consider researching these two options, then discuss with MD.
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christinex2ri May 2022
Alva, please know that a loved one who may need either Palliative or Hospice is not necessarily an elder but anyone who is in a chronic progressive medical illness, from COPD/heart disease/brain tumor/ even diabetes as well as cancer.
I agree with the rest of your statement discussing these 2 forms of care.
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What is IS? I haven't heard that term before. You are wise to become informed as much as possible about your choices before you feel a service is needed.

I tried Palliative Care for my DH but I stopped it when the Pandemic began. It was provided through a Hospice Agency. The benefit I appreciated was a nurse, social worker and chaplain available to visit once a month. A doctor was available for the nurse to consult as needed. I discontinued the chaplain since we had our own local church.

PROS - I chose it to have a new set of eyes and ears to check on us in our home in between regular doctor appointments. We could continue with any doctor, therapy, treatment or medication we already had in place. We could aggressively pursue and consider any new treatments we found.

CON - From the beginning, I felt like they were just wanting to be first in line should Hospice be needed. I had to repeatedly say DH was not ready to discontinue anything we already had in place. In fact, even though I insisted we were not ready for Hospice, the representative came to our home only with Hospice forms and no forms to sign us up for Palliative. I should have sent them away right then. Palliative care is not available 24/7 and has no respite care.

It is my understanding true Palliative Care can begin even from the beginning of a diagnosis of a chronic disease. The purpose is to give a unified team approach to planning and supervising the overall care of patients to provide information on resources (providers, financial, etc.) for the best quality of care even if there is no end-of-life in sight. I have found some Palliative Care programs that do just that but unfortunately I have not found that locally. It seems some Hospice programs are providing Palliative Care as a foot in the door for new patients and unfortunately some may give up sooner than necessary.

Search online both Palliative Care and Hospice Care to learn the various interpretations of the terms and see what is available in your area. I have seen the benefits and totally believe in Hospice at the right time and feel I will recognize the need when that time comes. I think Palliative Care is still evolving and widely varies from state to state.
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As far as I know they are both for end of life care. Hospice is when you have 6 months or less as diagnosed by a doctor. Palliative care is when you may live longer than that but drugs and other things are used to help your quality of life such as pain management. So, palliative care can turn into hospice depending on how your disease progresses.
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Thanks to all that replied to my question. Very helpful information.
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I'd always thought that hospice was for end of life care when there is an expected short timeline. However, when my H was recuperating from pneumonia in a rehab facility, their social worker suggested I talk with hospice because of the support they could provide and they arranged a meeting. Hospice took him on for the PDD diagnosis. I confirmed with them that he could continue to see his PCP or cardiologist. Of course PDD is ultimately fatal but that could be years away. However, the hospice company signed him on anyway despite not having an MD confirmation of possible death, I feel. A nurse at the rehab facility said his dad was in hospice for two years. A few months in, H was suffering periodic severe abdominal pain, so after talking to the hospice nurse (all they could suggest was pain meds, and I tried hydrocodone and it didn't work). I took him to the ER which did CT scans etc. Recently I received notification from Medicare that they did not cover his ER charges (almost $15,000!) because he was enrolled in hospice. We are appealing based on the fact that his ER visit was unrelated to PDD (the hospice company said to take this tact, as they think this is the case). In retrospect, thinking vs actually knowing the rules is a whole lot different! I'm hoping Medicare reconsiders! I've just removed him from hospice enrollment to avoid future denials of payment for specialists or ER. I frankly think that hospice companies are too anxious to enroll a patient, even if there is no 6 month prognosis of death! From what I've read since, the assumption by Medicare is that there is a 6 month or less life expectancy. Long story short, I offer this note as a caution against enrolling in hospice prematurely as it seems you give up your ability to seek emergency and possibly other care (such as physiotherapy). If he had broken a leg, I wonder if Medicare would deny ER care?!
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MJ1929 Jun 2022
If he goes to the ER, he is taken off hospice, and the billing goes through Medicare as a non-hospice patient. Once he's released, he's put back on Medicare.

Someone did the billing incorrectly, that's all.
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BeckyB72: Per Google "But palliative care is actually a new medical specialty that has recently emerged -- and no, it's not the same as hospice. It doesn't serve only the dying. Instead, it focuses more broadly on improving life and providing comfort to people of all ages with serious, chronic, and life-threatening illnesses."
Disclaimer - I did not author this.
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My 95 yo mother has dementia but is in otherwise fairly good health. I had her assessed by our regional "Hospice & Palliative Care" organization.

Because of her dementia, she qualifies now for ongoing hospice care which would provide care in the form of a hospital bed, an aide to help bathe her twice each week, bed pads, adult diapers etc.

However, I don't need any of these services at the moment, and if I had put her into the hospice program, Medicaid would have discontinued paying for her weekly physical therapy which she benefits from.

So, I have her currently under their Palliative care which is on an "as needed" basis. They have 24/7 availability if I need them.

When I feel that she's ready, they will transition her over to hospice. I did give consent to have the hospice doctor take over her care because they have more liberty in prescribing medications than her PCP.

It's only a phone call to the PCP to request orders be sent to your local palliative/hospice organization so they can come out and do an assessment.
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Palliative care is "comfort care," or treating symptoms to keep the person as comfortable as possible without trying to cure the underlying illness.

Hospice care is "comfort care" provided to somebody expected to live less than 6 months (time limits are usually defined by the state). The person is kept as comfortable as possible to allow interaction with others. Curing diseases is not the goal.
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Myownlife May 2022
Hospice is different nowadays, and imminent death is not necessarily the criteria. A person can actually start doing better and it can be discontinued, and down the road, restarted if needed.
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