Hospice is one of the most successful healthcare programs that we have in the United States. It is rare to hear even one negative comment when discussing the program. The only exception is that some doctor’s seem to want to control the patients care for too long, and therefore will not turn over the care to hospice soon enough.
However, I have recently noticed a trend in some assisted living and skilled nursing homes where they are mixing hospice and dementia residents due to the higher levels of care needed. Yet this creates three issues.
First, the Alzheimer's and dementia residents in this environment rarely have the activities focus that is so critical to the quality of life for a resident with cognitive issues. The care is relegated to containment, safety, and the basics.
Secondly, the unit becomes known as the “death wing.” You know the Eagles hit “Hotel California” and the final verse:
Last thing I remember, I was
Running for the door
I had to find the passage back
To the place I was before
'Relax,' said the night man,
'We are programmed to receive.
You can check-out any time you like,
But you can never leave!’
Residents, staff, and families know that once you go beyond the shut doors, there’s only one way out. While the families of those at hospices have been counseled to deal with this trauma of losing a loved one, many families of those with Alzheimer's or dementia are not at the same place, nor do they want to be.
Lastly, hospice residents and their families have completely different needs from Alzheimer’s and dementia residents. The programming is different, the care is different, and the environment should be different. While both programs are focused on quality of life vs. curative care, hospice care involves the family and loved ones in what is considered a natural process, not something that should be sped up or slowed down. It is incredibly important to allow the families to feel completely comfortable entering in to a hospice environment, which is difficult to achieve in a secured Alzheimer’s unit.