Hospice for a Stroke Patient

Last Updated: November 24, 2020

Written by the Open Caregiving Team. Editorial review by Joyce O. Murphy RN, MSN.

When to consider hospice for a stroke patient

A stroke affects a person’s nervous system, potentially causing other health problems. Some lead to pneumonia, trouble swallowing and communicating, or depression. Others impair the ability to move. Any of these contribute to your loved one’s decline and signs that it is time to consider hospice. These signs include:

  • Difficulty breathing and swallowing, possibly resulting in pneumonia.
  • A vegetative state that does not change. This means that your loved one’s body is able to do the minimal functions to maintain life. They cannot do anything for themselves.
  • Being in a coma, meaning your loved one is asleep and cannot be awakened.
  • The harm to your loved one’s brain has caused changes in muscle tone, causing involuntary movement.
  • Weight loss.

What is the hospice eligibility criteria for a stroke patient?

As you have read, the outcomes of a stroke are quite variable. Because of that, the eligibility criteria for hospice care for your loved one vary as well. It is up to a physician to decide when a person who has had a stroke is approved for hospice. That is based on a number of the following:

  • Your loved one has a hard time functioning, such as:
    • They cannot work or get out of bed on their own.
    • They eat and drink less than in the past.
    • They are drowsy and nod off frequently.
  • They have trouble swallowing, making it hard for them to take in food and beverages. They tend to gag a lot and may have had a recent bout of pneumonia.
  • Health has declined with more infections, skin ulcers, and fevers every now and then.
  • Recently lapsing into a coma without responding to your voice or when the doctor tests for pain.

What can hospice do for a patient after a stroke?

Your loved who has had a stroke and qualifies for hospice will receive symptom management care that:

  • Helps with safe eating and drinking, and how to care for swallowing and gagging concerns.
  • Supports safe mobility and moving around in bed, or into a chair or wheelchair. Your loved one’s weakness and imbalance mean that safety is a top priority.
  • Skin receives special care because of the potential for ulcers.
  • Helps with getting any special equipment and supplies needed for care, safety, and comfort. This can include large pieces such as a hospital bed.
  • Focuses on day-to-day cleanliness.
  • Includes assistance with communication.
  • Assures comfort measures are in place to manage pain, fever, and positioning, among others.

What can hospice do for the family of a patient after a stroke?

Caring for a loved one who has had a stroke involves physical, mental, and emotional demands. The hospice team is there to assist you and your family with family caregiver education, respite, and emotional support, such as:

  • Information and demonstration of ways to care for your loved one while maintaining safety for both of you.
  • Nurses and home health aides who show you the best way to use various pieces of equipment. They’ll also give you numerous personal care tips, such as those for skin and mouth care.
  • Help with getting the equipment and supplies you need when your loved one is in at-home hospice.
  • Volunteers and respite care to spend time with your loved one while you get some precious time for self-care.
  • Social workers and counselors to help you move through the emotional ups and downs of caring for a loved one who has had a stroke. This involves working with family dynamics and assuring you are setting aside time for yourself.
  • Therapists who will help you with communication and swallowing concerns.

Do certain hospice providers specialize in stroke patients or comas?

Most hospice providers specialize in caring for people who have had strokes since it is one of the top 5 causes of death in the U.S. This includes those who are in a coma. The hospice team for people with strokes or in a coma should include:

  • Physicians who have education and experience in diagnosing and prescribing care for people with varied loss of brain functions.
  • Nurses and home health aides with education, training, and experience caring for a variety of people who have had strokes. This includes people who have recovered to some degree after a stroke.
  • Counselors, social workers, and volunteers who respect the demands of caring for a loved one who has had a stroke.

Does Medicare cover hospice for stroke patients?

Yes, Medicare covers hospice for people who had strokes when your loved one:

  • Is enrolled in Medicare and the hospice you’ve chosen is Medicare-certified.
  • Is certified by a physician to be eligible for hospice care, meaning they have six or fewer months of expected life. The physician will base their decision on the eligibility signs and symptoms discussed above.
  • Chooses to forgo any curative therapies.

Does Medicaid cover hospice for stroke patients?

Medicaid coverage of hospice care for stroke patients varies by state. You can call your state’s Medicaid Office to learn more about your loved one’s eligibility.

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