Hospice in the Nursing Home

Many nursing homes or skilled nursing facilities (SNFs) do a wonderful job of providing appropriate care to people with dementia who cannot be cared for at home. But not all have the specific skills in symptom management, sensory stimulation and family support so crucial to a person with end-stage dementia. Therefore, it was not surprising to read about an analysis of hundreds of family surveys in the Journal of American Geriatrics Society, showing that “Hospice services substantially improved the provision of care and support for nursing home patients dying of dementia and their families.” For example, according to Dr. Joan Teno, a Brown University gerontologist and the lead author of the study,¬†one in five family members of patients not in hospice reported an unmet need for shortness of breath while only 6.1 percent for people in hospice did. Everyone benefits, including the SNF staff, by the additional resources of hospice: expertise in pain and symptom management, volunteers, spiritual and emotional support.

This research comes as Medicare funding for hospice has been swept up in the debate over the federal deficit. Hopefully the positive results of this study will increase awareness of dementia as a terminal illness and highlight the appropriateness of hospice in caring for people with end-stage dementia and their families in the SNF setting.

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