Predicting hospice appropriateness for patients with dementia of the Alzheimer's type.

The appropriateness of admitting individuals to hospice services is determined by assessing the individual's 6-month survival prognosis. Clinical parameters that guide clinicians in assessing prognosis, however, are not well defined in cases of dementia of the Alzheimer's type (DAT) when compared to other illnesses. The Alzheimer's-Hospice Placement Evaluation Scale (AHOPE) was developed to assess the 6-month prognosis of individuals with late-stage DAT. The purposes of this study were to estimate the reliability and predictive validity of AHOPE and to test additional demographic and clinical indicators to determine their added contribution to predicting 6-month survival and hospice appropriateness. Data were collected on 112 long-term care residents with DAT at enrollment and 6 months following enrollment. Initial reliability and predictive validity of AHOPE were supported. Other demographic and clinical indicators were not predictors of 6-month survival. Although additional research is indicated, nurses can use AHOPE to enhance clinical observation and decision making for implementing appropriate care strategies for patients with end-stage DAT and their families.