For someone with dementia, getting hospice coverage isn't easy - The Washington Post

"My mom’s death was perfect, and hospice helped. But her dementia made enrolling her and keeping her in hospice nearly impossible. She died during her second stint in hospice. The year she died, I had reached out to a hospice and palliative-care agency because my mom seemed to be heading downhill fast...The Medicare reimbursement schedule is tied to predicting when a person is within six months of death. People can linger in late-stage dementia for years. There are no scans, blood tests or other scientific ways to predict when a person with dementia will die. Making matters worse, in 2013 Medicare removed “failure to thrive” — one of the hallmarks of late-stage dementia and what some physicians call frailty — and debility as primary diagnoses for hospice entry. But people with dementia decline over years and years, and frailty is part of that decline...People don’t access hospice until the very end of life. Fifty percent have hospice care for fewer than 18 days, and 35 percent have a length of stay of seven days or less. “That’s really frustrating,” said Judi Lund Person, a vice president at the National Hospice and Palliative Care Organization. "

For someone with dementia, getting hospice coverage isn't easy - The Washington Post