As a caregiver, you may find yourself overwhelmed with decisions about what’s best for your loved one with dementia. Is it time for palliative care, hospice, or memory care?
In this episode, we break down these options, their differences, and how to make informed decisions that prioritize both your loved one’s comfort and your peace of mind.
Understanding Palliative Care and Hospice
Palliative care and hospice are often misunderstood as being the same, but they serve distinct purposes:
Palliative Care: Focuses on managing chronic conditions like dementia, COPD, or heart failure to ensure comfort without aiming for a cure. It’s appropriate for individuals who are still active but need extra support to maintain their quality of life.
Hospice: Comes into play when a condition is terminal, and the focus shifts to end-of-life care, providing emotional and physical support for both the patient and family.
A key point from the episode: Palliative care can start earlier than you think, even while your loved one is living independently or in assisted living.
When Is Memory Care the Right Choice?
Transitioning your loved one to memory care is one of the toughest decisions you’ll face. The episode highlights signs that it might be time, including:
- Increasing anxiety or confusion that disrupts daily life
- Difficulty managing tasks even with outside help
- Withdrawal of friends or community members as behaviors become harder to navigate
The discussion also emphasizes giving yourself grace during this decision-making process. It’s okay to take time to evaluate your options while remaining compassionate with yourself.
Key Questions to Consider
What’s their current quality of life?
If your loved one is still thriving in their current environment, focus on supporting them where they are.
Are their behaviors manageable at home?
Behavioral changes, like paranoia or heightened anxiety, may indicate the need for a more structured care setting.
Are you prepared for the inevitable?
Recognizing the progression of dementia helps in planning proactively rather than reacting during a crisis.
Leaning on Support and Faith
This episode reminds caregivers of the importance of early support. Engaging with a community, such as the Dementia Caregiver Support for Christians group, provides a space to ask questions and find guidance before decisions become urgent.
Faith also plays a central role in navigating these tough choices. Trusting in God’s timing and wisdom can provide peace, even when decisions feel overwhelming.
Read more:
How to Have a Good 2025 Even When Dementia Caregiving
Know When Isolation In A Person With Dementia Is Detrimental
Ever Wonder How To Know What Is Causing Your Caregiver Stress?
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[0:00] Are you confused about the differences between palliative care and hospice and0:05] how to make the decision for your loved one? Listen to today’s Dementia Caregiver Support in action and see how this conversation doesn’t need to be scary and overwhelming. Hey Christian Care Companion, welcome to Dementia Caregiver Support for Christians, the podcast where I teach Bible-believing Christians how to make dementia care easier today while helping you focus on a brighter tomorrow. If you are a Christian spouse, the adult child, or a family member of a person living with dementia, and you want to find an easier way, this podcast is for you.
[0:41] Here we look at kingdom-focused caregiving. We honor the Lord Jesus Christ in our caregiving journey, and we show you practical ways to make your caregiving easier. Join me in our Ask the Dementia Coach monthly meetup. Now, what are these monthly meetups? This is an opportunity for you to register to come into a small intimate Zoom room with me and a few other people. I keep the Zoom room small. I cap registration at about 20 people because I know not everybody shows up and typically four to five people can show up. And then we spend an hour together where you will have the opportunity to actually feel what it feels like to get live dementia caregiver support in action. So if you haven’t been to one of the Ask the Dementia Coach monthly meetups, I invite you to sign up for that and feel what it feels like to actually have
Understanding Palliative Care
[1:41] dementia caregiver support. And without waiting anymore, let us go to the conversation about the differences between palliative care and hospice, which is sometimes a scary conversation for family caregivers, but you will see through this conversation that it does not have to be.
[2:03] So palliative care and hospice, two sides of the same coin, okay? Palliative care is a way to help a person who has a chronic medical condition like congestive heart failure or COPD or Alzheimer’s or whatever, a chronic medical condition, manage the chronic medical condition, but not seeking or looking to cure said chronic condition, but to keep the person comfortable with that chronic condition. Okay. So that’s palliative care. That is palliative care. Now let’s talk about hospice. Okay. Okay. Hospice is different than palliative, but it’s the opposite side of the same coin. Okay. Hospice is brought in when a person has a diagnosis.
[2:57] That we know is terminal. Hospice, what hospice does is hospice is there to support her while she is passing away, support you and prepare you and her for inevitable death, right? And has additional services that come in. One of the things that hospice pays for, and we’ll talk about payer sources here in a second, But one of the things that hospice pays for is like an aid to come in twice a week to bath, to bathe somebody. But it’s not like the type, it’s not the kind of aid that you guys are doing. Like Angela was providing that aid and assistance, the 24-hour care, and between you guys and the aid, mom has the care she needs, right? So it would be a person who would come in and, in addition, help to give her a bath. A nurse comes out once a week, you know, as typically once a week, meet with the family, helps to oversee medication, et cetera, et cetera. Hospice provides equipment when a person needs it. So, for example, when the person gets to the point, like Mitch.
[4:11] You hear me talking to Mitch about the fact that, are we ready for a hospital bed yet?
[4:16] Right? So it doesn’t have to then go and buy a hospital bed. If you’re getting 24-hour care in the nursing home does not mean that you cannot have hospice on top of it. In a skilled nursing facility, I do not know, okay? Because typically in a skilled nursing facility, so I want you to think that palliative care would be more for mom as she’s living in the independent and probably in assisted living, right? Now with memory care, So sometimes with memory care, and it’s a really good question, the facility’s provider, doctor, right? Because when she moves into a memory care facility, they will have a doctor who is the overseeing physician of all of the residents in the memory care. So she won’t have her own providers anymore, right? Or she can still go see her primary care physician, but she’ll have an overseeing physician. Oftentimes in a memory care like that, that person might be more the palliative care side, but they can still have an outlying hospice come in. Sometimes they may have preferred providers, right? But if most places, if she already is working with a specific palliative care hospice company when she moves, most of the time, there is usually a way around that and that they can keep their providers, especially if it’s a better facility because they want those people coming into their buildings because then they get more referrals, right?
[5:45] Why would the doctor agree to a palliative care assessment? What has to be wrong?
Exploring Hospice Care
[5:52] Is your mom starting to lose weight? I don’t know that. I have to weigh her. Well, last time I weighed her, no. Okay. So palliative care can, you know, it can start. Bottom line is every doctor is different, but what you can do is ask, say, hey, my mom is 91. I’m really curious to see if she’s palliative care appropriate.
[6:10] She doesn’t want to leave the house to go to the doctor and be schlepped around all of these different places anymore. She’s tired. We don’t want to mess with it in the winter. Like lots of reasons. And they can do an assessment, right? And then they do an assessment and they will tell you based off of her, all of her diagnoses, everything that’s her whole medical picture, whether she qualifies or not. And is Alzheimer’s a diagnosis that is terminal? Yes and no. So most of the time, most people die with Alzheimer’s. They do not die from Alzheimer’s. So Angela’s mom just depends on how the hospice codes it in the end, whether she died of a UTI or whether she died of Alzheimer’s, right? Because they had her on hospice because of Alzheimer’s disease, but she was being treated for a UTI that went rogue and she went septic, right? She would have eventually died in any case, but most people who die with Alzheimer’s die because of an infection, a secondary
Making the Right Decision for Mom
[7:08] infection, like a UTI or an upper respiratory infection of some sort. I’m perplexed about what is right for my mother next. I will tell you what I think is right. And so when you asked me for this meeting, I immediately thought palliative care. I would get a palliative care consultation.
[7:28] Why? Because she’s 91 years old and because she’s changing, her cognition’s changing, and because she’s starting to now truly significantly impact her ability, right? This is truly in the almost 18 months we’ve been together that I can tell that your mom is changing, right? So you recall, we talk about the three buckets, right? Your mom is now solidly in that middle bucket. She started off here in the first bucket where she could still have good quality and all of that kind of stuff, but she’s now moving into that middle bucket, right? And what do you call the middle bucket? What are medical moderate dementia? So at the beginning, when we first started working, she was definitely male. So palliative care where she is versus memory care. Let me ask a question or let me, I don’t even know if it’s a question or a statement. I think we’re just delaying the inevitable. So here’s the question I want you to ask yourself.
[8:25] What’s the inevitable though? The inevitable is she’s dying. The inevitable is that I think your mom’s going to be in a memory care. Before she passes away? Yeah, I think so. Unless she just up and dies overnight, which none of us can control, right? Right. But based off of what you’re telling me, so here’s what I want you to consider. Here are the questions I want you, you guys are smart people. Here’s what I want you to consider. Right now, it is still a good situation for your mom, right? The people have not started to withdraw from her, her friends. They’re still with her. They’re still doing all of those kinds of things. They’ve kind of kept her under her wing. But if the things that are starting to happen now where she’s getting so super anxious and where she’s freaking out and where she doesn’t know where she is, et cetera, when that starts to happen and her friends start, those people start to pull away, that’s going to be hard for you to see happen. So she’s still in a pretty successful situation right now, and it’s been really, really good for her. How can I tell like over the next week?
[9:36] So I think there’s so many variables going on, right? She just came back from the cruise. Am I giving her enough time to readjust and she’ll readjust?
Assessing Memory Care Options
[9:47] Or am I just kidding myself and it’s time for memory care and I’m just postponing it? Now, by the way, I have all the paperwork for memory care right here on my right arm. She can’t move in until her doctor fills out paperwork. The doctor won’t see her until I forgot what day in December. So in a way, it’s an exercise in futility because I’m going to see her over the next couple of weeks anyway. She can’t even move in until January. So I don’t even know why I’m worrying about that. But I’m just sort of thinking. That’s how you have to process. And just be gracious to yourself, right? It’s okay. It’s okay. You are definitely, you are one of the, like your Colby index that we did, like you’re a nine fact finder.
[10:38] Out of eight? Bottom line is you need all of these details. Right. That is how you will make your decision. Right, right. You will know what the right decision is. People who are really benefiting from the community are the people who joined earlier on before they need it and that have been active and are participating in the community. Because then they already know what questions to ask and they have a place to come and they’re not constantly wondering, what do I need to do? How do I need to do it? So people listening are interested in tapping into or learning about the community. I’d invite you to just go to the website, thinkdifferentdementia.com.
Community Support and Resources
[11:24] There’s a link for you to schedule a 20 minute call. There’s no pressure. I’ll serve you regardless of whether you join the community or not, but it is a way for you to take this relationship a little deeper, a little bit more hands-on support, because really the research also shows its longitudinal support over time. Absolutely. Yeah, for sure. I would highly recommend Lizette. She’s awesome.
Closing Thoughts and Blessings
[11:48] I appreciate that endorsement. Thank you everybody for listening today. And as I try to remember, I try to remember, I don’t always remember, may the Lord bless you and keep you and come back and listen some more. I’m hoping to do more of these coaching style episodes. So come back in and check us out. And thank you for being here today.
