When Dementia Patients Become Eligible for Hospice

In order for patients to be considered eligible for hospice, they must be considered to have a prognosis of six months or less to live. For many illnesses, this can be a difficult prediction to make, including for dementia.

A recent study by Mitchell, Kiely, Hamel, et al published in the Journal of the American Medical Association (June 9, 2004 issue), came up with a list of risk factors that suggest a mortality of six-months or less:

1. male gender
2. cancer diagnosis along with dementia
3. congestive heart failure along with dementia
4. requiring oxygen within last 14 days
5. experiencing shortness of breath (dyspnea)
6. eating less than 25% of food at most meals
7. bowel incontinence
8. bed-bound
9. 84 years-old or older
10. sleeping most of the day
11. ADL (activities of daily living) score = 28 (I couldn't find the tool they used, but here is an example of an ADL scoring sheet
12. unstable medical condition

Having these guidelines can not only be helpful in determining eligibility for hospice, but can also be informative in letting families know when their loved ones are reaching the end of their lives.