Why Some Advanced Dementia Patients Don’t Get Hospice Care

Posted on 27. Oct, 2009 by Editor in Did You Know?

This step could ease pain among advanced dementia patients who are dying, researchers say.

Add advanced dementia patients to the long list of terminally-ill patients for whom the hospice benefit is underutilized, says a study recently published in the New England Journal of Medicine.

“Dementia is a leading cause of death in the United States but is underrecognized as a terminal illness,” researchers explain in their abstract. As a result, some advanced dementia patients suffer painful and “burdensome interventions” when a better choice is palliative care. ”People with advanced dementia are often given dialysis and put on ventilators; they may even get preventive care that cannot possibly help them, like colonoscopies and drugs forosteoporosis or high cholesterol,” explains Tara Parker Pope in The New York Times.

Why don’t some advanced dementia patients get the palliative and hospice care they need? “Patients with health care proxies who have an understanding of the prognosis and clinical course are likely to receive less aggressive care near the end of life,” concludes the NEJM abstract. That’s researcher-speak for: The more patients’ families understand that advanced dementia is a terminal disease, the more likely they are to choose hospice for their loved ones at the end of life.

The researchers followed 323 SNF residents with advanced dementia in 22 different nursing homes — and their families — for 18 months.

Available on CD or MP3: 5 ways to boost your hospice’s conversion rate.

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