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When Is It Time for Palliative Care or Hospice for Someone with Dementia?

Jenifer Garner, MSN, AGPCNP, ACHPN

Many patients and families living with dementia will, at some point in the disease process, need to add more support and services to aid in the care and support of themselves or their loved one. Two services that care for patients with chronic illness are: palliative care and hospice. Knowing when the right time to add palliative care and hospice can be challenging.  Although palliative care and hospice are similar in their philosophy and focus on quality of life, they are different in some essential areas.  When deciding when it is time for palliative care or hospice it is important to know the difference between the two.  Hospice and palliative care have many similarities; however, knowing the difference can help identify when to seek out one versus the other.

Palliative care is specialized medical care that focuses on the physical, social, emotional, and spiritual needs of patients and their families living with chronic illness. The root word in palliative care is palliate. To palliate is to “lesson the severity of (pain, disease, etc) without curing or removing” (Collins, 2014).  Palliative care can be provided at any time in the disease process ie. the beginning, middle, or end and can be provided alongside curative treatment. Palliative care collaborates and consults with the patient’s primary care providers and specialists to ensure the patient’s needs are being met. Palliative care is an extra layer of support and focuses on quality of life for persons living with chronic illness and can be provided at any time in the disease process and alongside curative treatment.

Hospice also focuses on a patient’s physical, social, emotional, and spiritual needs; however, hospice is provided at the end of life, when a patient has an expected life expectancy of 6 months or less.  Determining when a person has six month or less to live can be challenging to predict.  For patients with dementia, practitioners commonly utilize the following characteristics to determine if a person is at the end of life: FAST score (Alzheimer’s dementia); decreased functional status; dependence on others for two or more activities of daily living; and other comorbidities (CGS, n.d).  Hospice focuses on quality of life for persons who are considered terminally ill and have a six month or less prognosis.

Determining the right time to add supportive services for chronic illness can be challenging. Knowing what services are available and when they are best implemented can aid in the decision to pursue the right service at the right time.  Both palliative care and hospice are services that focus on quality of life and provide care for patients with dementia. Whereas, palliative care can be provided at any time during the disease process and hospice is provided when the person has a 6 month or less prognosis. 


Collins English Dictionary – Complete and Unabridged, 12th edition (2014). Retrieved from:

 Palliating – definition of palliating by The Free Dictionary

Celerian Group Company, CGS. “Hospice Terminal Prognosis: Dementia due to Alzheimer’s Disease.”

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