When Is Hospice Care Needed for Loved Ones Living With Dementia?

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It is never easy when your loved one reaches the time they need hospice services. However, it may become necessary when they reach the final stage of their life.

According to a National Hospice and Palliative care Organization (NHPCO) report, “in 2020, 21.2% of hospice patients in the United States had a primary diagnosis of dementia. This makes dementia disease the second most common primary diagnosis among hospice patients, after cancer ” [01].

Dementia disease and Alzheimer’s disease is a common disease among seniors in North America. This means many families will face the difficult transition into hospice care for their loved ones with dementia. Understanding the different stages of dementia, as well as what hospice care looks like for dementia, will help families make informed decisions for their loved ones in the final stages of their life.

Brain health and dementia

What Are the Stages of Dementia Disease?

Alzheimer’s and related dementias are progressive cognitive diseases that worsen over time. Many seniors with Alzheimer’s disease also experience Sundowner’s Syndrome, a syndrome with symptoms similar to Alzheimer’s.

Before we identify the varying stages of dementia disease, it’s important to note the difference between Alzheimer’s disease and dementia, as these two terms are frequently interchangeable and often lumped together.

Dementia is the general umbrella term for a cognitive disease that affects memory, reasoning, or other thinking abilities. Whereas Alzheimer’s disease is a specific disease that accounts for 60-80% of dementia cases, according to the Alzheimer’s Association [02].

Since Alzheimer’s disease accounts for more than 60% of dementia cases, we will narrow our focus to Alzheimer’s disease throughout this article, as many individuals suffer from it as they age.

Several stages of Alzheimer’s disease and dementia disease progress throughout a person’s life. Stages include:

1) Preclinical Stage Dementia: 

In the preclinical stage, many individuals rarely show signs of dementia. This stage can arise years before any symptoms show, and most individuals live independently for years prior.

2) Early Stage Dementia:

At this stage, a few symptoms can develop, including mild forgetfulness, which can be confused with age-related concentration problems. People can still live independently at this stage but may struggle with remembering names, managing finances, recalling recent events, or staying organized. At this stage, families tend to appoint a family caregiver to check in with their loved one or help when needed with paying bills and organizational tasks, for instance.

3) Moderate Middle Stage Dementia

With moderate-stage dementia, individuals may experience dementia symptoms such as difficulty learning new things, trouble remembering events, difficulty with reading and writing, becoming moody or withdrawn, etc. These symptoms are more concerning than early to mid-stage dementia and may need further attention.

At this stage, many family caregivers step in to help out or appoint a caregiver to assist with day-to-day tasks or physical assistance.

If you or a loved one is diagnosed or living with mid-stage dementia, call us at 1-877-588-8609. Our Nurse, Next Door Care Designers, can assist families with creating a tailored Alzheimer’s or Dementia care plan suited to each individual to help them live with dignity independently for as long as possible.

4) Severe Late Stage Dementia

The final stage of dementia is known as “severe or late-stage dementia.” This stage is also known as “advanced dementia.” At this point, people living with advanced dementia may lose their physical abilities, lose bowel and bladder control, have difficulty conversing, eating, and drinking, will need full-time support with daily living, and are susceptible to multiple infections, including pneumonia.

This stage of dementia typically requires full-time care from a professional licensed nursing provider like Nurse Next Door.

Nurse Next Door Nurse

When Is It Time for Hospice With Dementia?

Knowing the different stages of dementia disease can help you determine when it is time for hospice care. Typically a doctor will help your loved one and family members determine when it is the right time to seek hospice services for dementia patients.

When a person reaches the severe to late stage of Alzheimer’s disease or dementia, this typically is the time they will require a hospice team to join forces if their symptoms continue to decline. A hospice team may comprise hospice care nurses, hospice providers, social workers, doctors, and physical therapists.

What Are the Signs of End-Stage Dementia?

There are some tell-tale signs that a person is in an advanced stage of dementia. Signs include:

  • Unable to move on their own without assistance
  • Unable to perform daily tasks independently, including bathing, eating, or dressing
  • Incontinence might occur frequently or almost always
  • Frequent hospital visits.

How Long Does the End Stage of Dementia Usually Last?

It is never easy to see a loved one suffer. Especially when a loved one reaches the end stage of dementia, it can be devasting for families to witness. Fortunately, end-stage dementia is typically the shortest stage. According to the Alzheimer’s Society UK, “typically, on average, the end stage lasts no more than one to two years.” That being said, the last stage of dementia can be the most difficult, where an individual’s condition will severely impact their life.

If you have questions about advanced dementia, contact one of our Care Specialists, who can guide you through end-of-life expectations for care and treatment.

Hospice with Nurse Next Door

What Does Hospice Care Do for Dementia Patients?

Dementia-related illnesses and late-stage Alzheimer’s disease can be a difficult and emotional battle for patients and family members—hospice care tailors to patients’ comfort in the advanced stage of dementia, affecting their life expectancy.

Hospice care services can be provided at home, in a hospice care facility, long-term care facility, or in a hospital. Hospice care can support advanced-stage dementia patients in the following areas:

Individualized care plans

Nurse Next Door’s Care Designers will build custom care plans tailored to your loved one’s condition and end-of-life care.

If your loved one has been diagnosed with dementia, begin the advance care planning as soon as possible so you and your family prepare for the worst. Though we always hope for the best, our team ensures to meet all of your loved one’s advanced care planning criteria and provide support services where needed.

End-of-life care at home

Nurse, Next Door’s devoted team of professional end-of-life caregivers, will support your loved one at home or wherever they live in the final stages of dementia. We offer hospice care to dementia clients and provide comfort, alleviate symptoms, provide daily personal care, emotional and spiritual support, manage pain, and a tailored hospice program designed to encapsulate as many, if not all, of your loved ones’ care wishes.

Coordination with hospice teams

Nurse Next Door goes above and beyond when it comes to the end of life care. We make sure to take into account your entire hospice care team when developing your care plan. The hospice care team is the foundation for a peaceful transition and journey to the next phase, from doctors to social workers to hospice staff to family members. Nurse Next Door is committed to adequately coordinating all hospice providers and ensuring smooth communication throughout the entire process. We are here for you every step of the way.

Emotional and spiritual support

A significant factor we consider when it comes to hospice care or end-of-life care is the emotional toll it puts on families. We know that the final stages of dementia are the most complex and painful to witness in a loved one. Therefore we provide compassionate support services to our clients and their families throughout their journey with us.

We know how hard dementia can be, and we are there every step to offer family members and family caregivers respite services, guidance, and other hospice resources so families can feel supported during this difficult time.

For more information on how Nurse Next Door can support Alzheimer’s and dementia clients, visit our in-home Alzheimer’s and Dementia care page.

You and your loved one deserve comfort, quality of life, and respect for your personal treatment decisions and cultural or spiritual practices at every stage. Nurse Next Door promises to provide you with dementia support at any stage at home or in a care facility. Learn more with a complimentary Caring Consult from one of our Care Designers who can support you and your family as you navigate the next chapter.


Nurse Next Door is here to help your loved one with hospice care and dementia care.

Give us a call toll-free at +1(877) 588-8609 to get started!

Or read our Caring Blog for more articles on senior topics.

Related Articles:

5 Early Signs of Dementia

Alzheimer’s and Dementia: Things You Need to Know



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