Hospice Improves Care Quality for Older Adults with Dementia in Their Last Month of Life

Krista Harrison
Irena Cenzer
Claire Ankuda
Lauren Hunt
Melissa Aldridge
Peer-Reviewed Article
June 2022


While the Medicare hospice benefit has historically been designed to meet the needs of patients with cancer, people with dementia and their caregivers experience better outcomes when enrolled in hospice. 


The Medicare hospice benefit was originally designed around end-of-life cancer care. Now, almost half of all older adults receiving hospice care have dementia. Hospice care, whether provided in the home or in a health care facility, has the potential to improve the end-of-life experience for people living with dementia and their families. This study used survey data to assess how hospice enrollment impacts the quality of end-of-life care for people with dementia.


Proxies for individuals with dementia in hospice care reported care to be excellent, well-coordinated, and offer better management of anxiety and sadness. Hospice care for people living with dementia is associated with better caregiving ratings and fewer unmet needs. People with dementia enrolled in hospice had a higher quality of care compared to those not in hospice care.


Policymakers should consider the benefits of hospice for people living with dementia and their families when evaluating changes to hospice policy, especially changes to expand hospice access for people with dementia.

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