Referral for those with late-stage dementia should weigh experienced clinical judgement, Functional Assessment Staging (PDF, 37 KB) guidelines, and input from patients and family members.
Physicians, and admissions coordinators at our local Compassus programs are available to help with eligibility and referrals.
Patients will be considered to be in the terminal stage of Alzheimer’s disease if they meet the following criteria: 1 plus either 2 or 3 MUST be present:
Additional criteria lend additional support to terminal status:
- Inability to communicate meaningfully (1 to 5 words a day)
- Non-ambulatory (unable to ambulate and bear weight)
- All intelligible vocabulary lost
- Unable to sit up independently
- Unable to smile
- Unable to hold head up
- Liver Disease
- Renal Failure
- Neurological Disease
- Recurrent or intractable infections, such as pneumonia or other URI
- Pyelonephritis or other urinary tract infection
- Decubitus ulcers, multiple, stage 3-4
- Fever, recurrent after antibiotics
- Inability to maintain sufficient fluid and calorie intake demonstrated by either of the following: 10% weight loss during the previous six months OR Serum albumin < 2.5 gm/dl
- Aspiration pneumonia
If a patient meets the dementia-related medical criteria above, they are by definition eligible to receive hospice services. Some patients may not meet the criteria, but may still be eligible for hospice care due to comorbidities or rapid functional decline.
Contact our local Compassus program for further information.