How to Navigate Home Hospice Care for Dementia in Westchester County

Yes, a person living with Alzheimer’s disease or another form of dementia can receive home hospice care in Westchester County once their doctor and a hospice physician agree that, if the illness follows its usual course, their life expectancy is six months or less. Medicare Part A covers it, and “home” includes a private house, an assisted living community, or a nursing home.

Dementia-related illness is now the most common diagnosis group in Medicare hospice. According to the CMS Hospice Monitoring Report (April 2026), Alzheimer’s, dementia, and Parkinson’s made up 21.9% of Medicare hospice patients in fiscal year 2025, more than cancer.

Still, many families aren’t sure when hospice fits, because dementia changes so slowly. This guide explains how eligibility works, what home hospice care actually does for someone with advanced dementia, what it doesn’t cover, and how Westchester families can get started.

Can Someone With Dementia Get Hospice Care at Home?

Yes. Under the Medicare hospice benefit, a person with dementia qualifies when a doctor certifies a prognosis of six months or less and the person, or their legal decision-maker, chooses comfort-focused care. Most hospice visits happen wherever the person lives.

For families in Westchester, that usually means one of three settings:

• A family home: the hospice team visits on a schedule, and a nurse is reachable by phone around the clock.
• An assisted living community: the hospice team works alongside the residence’s staff.
• A nursing home: hospice adds its own nurses, aides, and social workers to the care the facility already provides.

The person keeps Medicare coverage for health problems unrelated to dementia. Only treatment aimed at curing the terminal illness stops.

When Is a Person With Dementia Eligible for Hospice?

A person with dementia is generally considered for hospice when they can no longer walk, dress, or bathe without help, have lost meaningful speech, and have had a serious complication in the past year. Doctors use national guidelines to judge this, but no single checklist decides it.

The guidelines most hospices use, published by the National Hospice Organization and summarized in American Family Physician, look for stage 7 on the FAST scale (Functional Assessment Staging, a 7-stage measure of daily abilities in dementia). At that stage, a person typically:

• Can’t walk, dress, or bathe without assistance
• Has bladder or bowel incontinence
• Speaks six or fewer understandable words, or repeats the same phrases

The guidelines also look for at least one of these within the past 12 months: aspiration pneumonia, a kidney or upper urinary tract infection, a bloodstream infection, deep pressure sores, fevers that return after antibiotics, or trouble eating and drinking enough, shown by a 10% weight loss over six months.

These are guides, not hard rules. The same AFP article notes that predicting life expectancy in dementia is difficult, and some people live much longer than expected. If you’re seeing changes, it’s reasonable to ask for an evaluation. Our article on signs it may be time for hospice care covers other changes families notice first.

What Does Home Hospice Care Do for Someone With Advanced Dementia?

Home hospice care for dementia focuses on comfort: reading pain the person can’t put into words, making eating safer, easing agitation, protecting fragile skin, and helping the family plan for infections before they happen. A nurse leads the plan, and a physician, aide, social worker, and chaplain round out the team.

Here’s what that looks like day to day.

• Recognizing pain without words. People with late-stage dementia often can’t say they hurt. The National Institute on Aging notes that pain may show up as groans, sighs, grimacing when touched, agitation, or guarding a sore part of the body. Hospice nurses are trained to watch for these signs and adjust medication.
• Safer eating and drinking. Swallowing problems are common late in dementia and raise the risk of food entering the lungs. Hospice teams teach careful hand feeding: small bites, upright posture, and no rushing. The American Geriatrics Society does not recommend feeding tubes for older adults with advanced dementia, because hand feeding offers the same nutritional benefit without the added risks.
• Calming agitation. Familiar music, gentle touch, a quiet room, and a steady routine can lessen restlessness. Medication is added when it’s needed.
• Protecting the skin. Once someone stops walking, pressure sores can form quickly. Hospice covers equipment such as a hospital bed and pressure-relieving mattress, and the aide helps with turning and bathing.
• Planning ahead for infections. Pneumonia and urinary infections are common in late-stage dementia. The team helps families decide in advance whether they’d prefer comfort treatment at home or a trip to the hospital, so no one has to make that choice in a crisis.

How Long Can Someone With Dementia Stay on Hospice?

There’s no fixed limit. Medicare covers two 90-day benefit periods, then an unlimited number of 60-day periods, as long as the hospice physician recertifies that the person still qualifies.

Because dementia can level off for a while, some people stabilize enough that they no longer meet the guidelines. When that happens, the person is discharged from hospice, keeps regular Medicare, and can return later if their condition changes. It isn’t a failure; it usually means the comfort care is working. Our post on how long someone can stay on hospice walks through recertification in more detail.

How Does Hospice Support the Family Caregiver?

Hospice cares for the whole family, not just the patient. That includes caregiver education, emotional support from a social worker, spiritual care, short breaks through respite care, and grief support after a death.

Caring for a parent or spouse with dementia is physically and emotionally heavy, often for years. If you’re feeling worn down, our guide to spotting caregiver burnout may help. Support available through home hospice care in Westchester, NY includes:

• Respite care: the person can stay in an approved facility for up to five consecutive days so the caregiver can rest, according to CMS.
• Bereavement support: Medicare requires hospices to offer grief support for up to a year after a death. Jansen’s bereavement services extend to 13 months and include free support groups at our White Plains office.
• Dementia-specific help: the Alzheimer’s Association Hudson Valley Chapter serves Westchester County from its office in Purchase, and the Association’s 24/7 Helpline is 800-272-3900.

Questions to Ask a Home Hospice Provider About Dementia Care

Not every hospice approaches dementia the same way. These questions help you compare providers in Westchester:

• How do your nurses assess pain in someone who can’t speak?
• How often will the nurse and aide visit at first, and how does that change?
• Who answers the phone at 2 a.m., and how fast can a nurse come?
• How do you work with assisted living or nursing home staff?
• Where would respite care take place, and who arranges it?
• Are you Medicare-certified and accredited by an outside organization?

How to Start Home Hospice for Dementia in Westchester

1. Talk with the person’s doctor. Share the changes you’ve seen in walking, speech, eating, weight, and infections.
2. Request a hospice evaluation. A doctor can make a referral, but families can also call a hospice directly to ask about one.
3. Meet with a hospice nurse. The nurse reviews the medical history and visits the person to assess their condition.
4. Sign the election form. If the person can’t decide for themselves, their health care agent or legal decision-maker signs.
5. Build the care plan. The team sets visit schedules, orders equipment and medications, and explains who to call, day or night.

Our referrals and admissions page explains how this works at Jansen.

Talking With Jansen About Dementia Care at Home

Jansen Hospice and Palliative Care is a not-for-profit hospice in White Plains that has cared for families in Westchester County since 1984. We’re licensed by New York State, certified by Medicare and Medicaid, and accredited by The Joint Commission, and our team is glad to answer questions about dementia care, even if you’re not ready to decide anything yet.

Learn more about our home hospice care services, or contact us to talk with our team.

Frequently Asked Questions

What stage of dementia qualifies for hospice?

Most hospices look for stage 7 on the FAST scale, the most advanced stage of dementia. At this point, a person usually needs help to walk, dress, and bathe, has incontinence, and can say only a handful of words. Doctors also look for a serious complication in the past year, such as aspiration pneumonia, repeated infections, deep pressure sores, or significant weight loss from trouble eating. That said, these are guidelines, not a strict test. Other conditions that add to a person’s overall decline, such as heart or lung disease, may also be considered. The best way to know is to ask the person’s doctor or a hospice nurse for an evaluation. An evaluation doesn’t commit you to anything, and it often answers questions families have been carrying for months.

Does Medicare pay for home hospice care for Alzheimer’s?

Yes. Medicare Part A covers hospice care for Alzheimer’s disease and other dementias when a doctor certifies a life expectancy of six months or less. Coverage includes the hospice team’s visits, medications for comfort and symptoms, medical equipment such as a hospital bed or wheelchair, and supplies like incontinence products and wound dressings. You may owe up to $5 per prescription and 5% of the cost of inpatient respite care. What Medicare does not cover is room and board in assisted living or a nursing home, or a private caregiver at home. Medicare also keeps paying for care unrelated to dementia, such as treating a broken wrist. If you have questions about your specific coverage, a hospice’s intake team can check benefits with you before admission.

Can a person with dementia stay in assisted living while on hospice?

Yes. Hospice can come to an assisted living community just as it would to a private home. The hospice team adds nursing visits, aide help with bathing and personal care, a social worker, chaplain support, and the medications and equipment related to dementia. Assisted living staff continue to handle daily routines, meals, and supervision. Good communication between the two teams matters a lot, so ask the hospice how it shares updates with facility staff and with the family. One thing to plan for: Medicare doesn’t cover the monthly assisted living fee. Families typically keep paying that through private funds, long-term care insurance, or other benefits the person already has. Staying in a familiar place often helps a person with dementia feel calmer.

What happens if my parent with dementia improves on hospice?

It happens more often than people expect. Good symptom care, steady routines, and attentive hand feeding can help someone with dementia stabilize, sometimes for months. If the hospice physician finds that your parent no longer meets the eligibility guidelines at a recertification visit, they’ll be discharged from hospice. That’s called a live discharge. Your parent keeps full Medicare coverage and can go back to their regular doctors. If their condition changes again later, they can be re-evaluated and re-enroll in hospice. Before a discharge, the hospice should help you plan next steps, such as home health aides, palliative care, or community programs, so there’s no gap in support.

Is hospice care for dementia different from hospice for cancer?

The benefit and the team are the same, but the day-to-day focus often differs. Dementia usually declines slowly, with long plateaus, while many cancers follow a more predictable path. That means dementia patients may be on hospice longer and may move on and off service. Care also leans heavily on reading nonverbal cues, because many people with late-stage dementia can’t describe pain, nausea, or fear. Families tend to need more help with practical questions about feeding, swallowing, bathing, and whether to treat infections. Caregiver support matters a great deal too, since many dementia caregivers have been providing hands-on care for years before hospice begins.

Glossary

• Alzheimer’s disease: The most common cause of dementia. It slowly damages brain cells, affecting memory, thinking, and eventually basic body functions.
• Dementia: A general term for a decline in memory and thinking severe enough to interfere with daily life.
• Hospice: Comfort-focused care for people with a life expectancy of about six months or less, plus support for their families.
• Palliative care: Care that relieves symptoms and stress of serious illness at any stage, with or without curative treatment.
• Aspiration pneumonia: A lung infection caused by food, liquid, or saliva going into the airway instead of the stomach.
• Dysphagia: Difficulty swallowing. It’s common in late-stage dementia.
• Pressure ulcer: A skin wound, also called a bedsore, caused by staying in one position too long.
• Feeding tube: A tube placed into the stomach to deliver nutrition. It’s generally not recommended for advanced dementia.
• Respite care: Short-term care that gives a family caregiver a break.