Care and placement options in the final stages of life


Maria Patino


A terminally ill patient’s deteriorating medical condition, increased physical safety needs, and the 24-hour demands of final-stage care often mean the primary caregiver will need additional in-home help, or for the patient to be placed in a hospice or other care facility. In many cases, patients prefer to remain at home in the final stages of life, in comfortable surroundings with family and loved ones nearby.

While every patient and each family’s needs are different, multiple changes can be difficult for a terminally ill patient, especially one with advanced Alzheimer’s disease or other dementia. It’s easier for a patient to adjust to a new home or care facility before they’re at the end stage of their illness. In these situations, planning ahead is important.

Hospice and palliative care at home or in a hospice facility

Hospice is typically an option for patients whose life expectancy is six months or less, and involves palliative care (pain and symptom relief) to enable your loved one to live his or her final days with the highest quality of life possible. Hospice care can be provided onsite at some hospitals, nursing homes, and other health care facilities, although in most cases hospice is provided in the patient’s own home. With the support of hospice staff, family and loved ones are able to focus more fully on enjoying the time remaining with the patient.

When hospice care is provided at home, a family member acts as the primary caregiver, supervised by the patient’s doctor and hospice medical staff. The hospice team makes regular visits to assess the patient and provide additional care and services, such as speech and physical therapy or to help with bathing and other personal care needs. Hospice staff members remain on-call 24 hours a day, seven days a week.

A hospice team provides emotional and spiritual support according to the wishes and beliefs of the patient. They also offer emotional support to the patient’s family, caregivers, and loved ones, including grief counseling.

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