More are using SNF hospice, sparking worries about cuts

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Residents in nursing homes who have dementia are using hospice care benefits to a greater degree than ever before, according to a new analysis.

Researchers also found that two in five nursing home residents suffered from some stage of dementia at the time of death.

Their study is believed to be the first to estimate the percentage of residents who died with mild to moderately severe dementia, or an advanced degree of it.

Researchers said that from 1999 to 2006, the proportion of those who used Medicare hospice almost tripled, and the duration of care more than doubled.

Study authors said they were pleased to see hospice benefits being used to a greater extent. But they also worry that rule makers would see a reason to cut costs, said lead researcher Susan Miller, a Brown University gerontologist.

“Initiatives focusing on reducing long hospice stays could disproportionately and adversely affect the timing of hospice referral for persons with dementia,” wrote Miller and her co-authors, Julie Lima and Susan Mitchell.
“It is critical that the creation of any new policy explicitly consider the challenges inherent in the timing of hospice referral for nursing home residents dying with dementia,” they added.

Study results were published in the December issue of the American Journal of Alzheimer's Disease and Other Dementias.

The Alzheimer's Association and the National Institute on Aging worked together to fund the study.
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