“People with dementia get sicker inch by inch,” said Lin Simon, director of quality at Gilchrist Hospice in Baltimore, the largest hospice organization in Maryland. “Trying to say, ‘Now, she’s ready for hospice’ is much harder.”
Yet doctors serve as the gateway to hospice, which provides palliative care for the dying and support for their families. Medicare regulations require a physician to certify that a patient entering hospice is likely to die of his or her disease within six months. Doctors are more likely to do so when the disease is cancer or heart failure, which have more predictable trajectories.
That’s the major reason that dementia patients — who can benefit from the better pain control, fewer hospitalizations (so often associated with aggressive treatments that confer no measurable benefit) and greater family satisfaction that hospice has been shown to provide — are under-enrolled in hospice programs.

This quote, from a post on The New York Times “New Old Age” blog, by Paula Span, brings to light a frequently overlooked aspect of hospice care. A significantly lower number of dementia patients are admitted to hospice care as opposed to patients suffering from other conditions because of the difficulty in making a precise prognosis of their health, even though the benefits they gain are proven and significant. There is good news, though. Researchers are creating new standards and ways of more accurately diagnosing this often misunderstood disease, and with this research comes the hope of better care and more comfortable living.

Read more http://hospicecarecorpblog.blogspot.com/2010/11/dementia-patients-miss-out.html