Nursing home hospice services boosted care and support for residents dying of dementia and their families, according to new research.

In contrast, people whose loved ones died from dementia while receiving skilled nursing care without hospice reported more unmet needs, such as shortness of breath or poor pain management, according to Brown University researchers. The investigators, led by Joan Teno, M.D., surveyed 538 family members of nursing home patients who died of dementia. In this group, 260 of the dementia patients received hospice services while 278 did not. Researchers also found that people whose relatives receive hospice care “too late” had more concerns about care and support, and even felt worse off than those families who had no hospice care at all.

Teno said the unpredictability of dementia’s progression can leave afflicted patients in hospice care longer than people with other fatal illnesses, a trend that has caused some controversy over Medicare payments.

“It is a terminal illness,” Teno said. “As we do payment reform, we should preserve access and quality of care for those persons dying of dementia.”

The National Institute of Aging funded the study, which appears in the Journal of the American Geriatrics Society.