Jun 11, 2008 10:00 AM CST

Is Covenant Hospice for Alzheimer’s Disease Sufferers? The Answer is, “Yes.”

Covenant Hospice services are geared to be supportive for the patient and the family. Most of their hospice patients are cared for in their homes, although Covenant Hospice also supplements the care given to terminally ill nursing home, assisted living facility, and the residents of other home-like facilities. In the areas served by Alzheimer’s Family Services, Covenant Hospice is often able to provide specialized inpatient care in a homelike facility staffed by the hospice professionals.

However, even though a large amount of care is provided in facilities, most patients can remain in a private residence with their family members being the primary caregivers. Covenant Hospice provides a team of professionals to assist but not to take over the care. The hospice nurse visits the patient as often as clinically needed, but at least once a week, and performs assessments to see if there has been any change of status or if new measures might be beneficial for the patient or family. When needed, a home health aide is sent into the home to assist with personal care. Chaplains are available if requested for spiritual support. Covenant Hospice social workers, in additional to social services direct support, also provide information about additional community services and helps coordinate access to those services. Covenant Hospice also has its own physicians who will visit the patient and provides a medical liaison to the patient’s primary physician. When necessary, the Covenant physician is available to assume the primary physician’s role. Some families request a hospice volunteer to help in ways similar to that of a friendly neighbor. For example, the volunteer might keep the patient company while the caregiver runs an errand. Thus, there are a great many services available through Covenant Hospice, which augment and support the services provided by Alzheimer’s Family Services.

Covenant Hospice is able to provide services to patients with a life expectancy on one year or less, although most patients have six months or less to live, that is also the eligibility period for Medicare and Medicaid reimbursement. Although Alzheimer’s disease (AD) is a terminal illness, its progression is so slow over a period of years that it is sometimes difficult to determine when the life expectancy has reached the level, which permits admission to hospice. Physicians sometimes have trouble predicting life expectancy especially when the patient is one whom they have followed for years. Families also have trouble realizing when the critical point has been reached. Because of these and other difficulties, the National Hospice and Palliative Care Organization professionals who treat AD patients have arrived at a set of guidelines that outline what signs and symptoms to look for to help with the prediction of life expectancy, and particularly in the period of one year or less. As we know, AD patients gradually lose physical as well as mental capacity. It is by comparing these guidelines to the abilities of the AD patient, that a six-month life expectancy and hospice eligibility can be determined.

When the AD patient has six months or less to live, he or she is:
Unable to ambulate without maximum assistance,
Unable to sit
Cannot dress himself without assistance,
Cannot bathe himself,
Is incontinent of bowel and bladder,
Is unable to say more than 6 meaningful words a day
Is unable to hold his head up
Does not smile.

If there are other recent complications the life expectancy drops to less than six months. These complications may include:

Aspiration pneumonia
Hip fracture
Recent stroke
Kidney infections (not bladder infections)
Multiple bed sores
Recurrent fever after antibiotic treatment.
Refusing to eat or difficulty swallowing

If you look at these guidelines and believe that your AD patient is ready for the services that Covenant Hospice can provide, or would like an evaluation by a Covenant professional contact AFS or Covenant Hospice or ask your primary physician and request a hospice referral.

Covenant Hospice Admissions: (850) 433-2155 or (800) 541-3072