My grandfather recently took my grandmother to see the primary care physician for a routine checkup. He told my grandfather that he thought my grandmother was ready for hospice (believe me she's definitely not there yet). My grandfather was really freaked out because people associate hospice with palliative care for those that have 6 months or less to live. The doctor explained to him that this was simply a way to get some additional resources for my grandmother since she didn't qualify for medicaid. A week after the doctor gave the referral for this program (which is medicare run), a doctor, social worker, and a rabbi came to the house to evaluate her! Full service, right?! It gets better... The doctor evaluated her medication and told my grandfather she didn't need to be on aricept and namenda anymore because these aren't effective in late stage and can lead to more aggression (something I have also read). The program has a caregiver "team" that is assigned to a certain number of patients throughout a few zipcodes, and meets regularly to discuss treatment plans for these patients. The group includes a doctor, cna, nurse, pharmacist, social worker, and rabbi/chaplain (depending on your denomination). It includes someone that comes to the house for a few hours a day 4 times a week, usually the cna, to wash her, make her food, dress her, and take care of any other ADLs she may need help with. Furthermore, if my grandfather thinks there is a problem medically that needs attention they will send out a doctor or nurse (depending on severity) to evaluate her at the house.
I have never heard of this program, and I am surprised that medicare has enough money to run a service like this. I don't want to get anyone's hopes up because maybe you have to be in really severe stages to qualify for this, but it's worth a shot.

Hospice was an absolute godsend for me. I don't know what I would have done without them. I do know that medicare has a criteria for AD patients to qualify. I'll see if I can find it.

Criteria For Eligibility for Medicare Hospice Benefit

Stage 7 or beyond according to the FAST scale
Unable to ambulate without assistance
Unable to dress without assistance
Unable to bathe without assistance
Urinary or fecal incontinence, intermittent or constant
No meaningful verbal communication, stereotypical phrases only, or ability to speak limited to six or fewer intelligible words
Plus one of the following within the past 12 months:
Aspiration pneumonia
Pyelonephritis or other upper UTI
Septicemia
Multiple stage 3 or 4 decubitus ulcers
Fever that recurs after antibiotic therapy
Inability to maintain sufficient fluid and calorie intake, with 10 percent weight loss during the previous six months or serum albumin level less than 2.5 g per dL (25 g per L)

FAST = Functional Assessment Staging Scale; UTI = urinary tract infection.

**Information from Schonwetter RS, Han B, Small BJ, Martin B, Tope K, Haley WE. Predictors of six-month survival among patients with dementia: an evaluation of hospice Medicare guidelines. Am J Hosp Palliat Care 2003;20:105-13.

Aitan,
I'm really glad you have hospice there to help you. Bill has been under their care since March and they have been a God send.
Not only will they provide the extra help you need, they will also provide the medical equipment, depends and medicines needed. They have volunteers who will come into your home and just stay with your LO so you can get out of the house. Also they provide a 5 day respite. The LO will be admitted to a care unit for 5 days just to give you time to recoup. This has helped me as much as anything. Bill goes into respite every month. They are getting the paper work in process so he can get in earlier this month so I can go see my brother.

Bill's nurse told me they were having seminars to educate people to the fact that Hospice doesn't just mean death is imminent.
The criteria that Lori mentioned doesn't all have to be met to qualify. If they have any of these, they could qualify.
When Bill and I came to our summer home, I told his nurse we wanted to go and she immediately got on the phone and contacted Hospice up here. Someone was here the same day we arrived to check on Bill and see what equipment we needed. That equipment was delivered the next day.
They will be here as much or as little as needed.

Anyone who is caring for a LO in the late stages should call Hospice and have someone come out and evaluate their LO to see if they qualify. I for one never thought Bill would qualify, but thanks to his primary doctor (he took it upon himself to call Hospice and had them come out)

Also you can keep your own doctor, you do not have to switch to the hospice doctor.

Make use of everything Hospice has to offer to help you and your grandfather.

Aitan, I'm glad your grandfather is tapping into the resources hospice has. I no longer am afraid of the word and my plan (if mom remains pretty physically healthy) is to do this when the time comes.

Aitan,

I, like your grandfather thought hospice was for the end. Thanks so much for letting us know all that. And Lori and Joyce, thanks for your info also. I just printed it all out. I'm sure glad your grandfather was able to get all that for your grandmother, and that medications seem to be adjusted now.

Jackie