Researchers have noted that increasingly more number of people isn’t getting required amounts of hospice treatment because of faulty admission criteria.

Dementia, the leading cause of death in the U.S., requires a lot of hospice care. Dr. Susan L. Mitchell, a senior scientist at the Institute for Aging Research at Hebrew SeniorLife in Boston, and lead author of a new study, said the admission guidelines suggest practitioners to wait until an estimated life expectancy of six months.

Researchers agree these kinds of predictions are definitely tough to make, especially with certain dementia patients.

Such palliative care, which is mostly provided to cancer patients, doesn’t require any such predictions as they are often suggested for those who forego chemotherapy or radiation treatments. However the decision process on providing such care to dementia patients is more complicated. As such patients already receive round-the-clock care, doctors think twice before offering hospice care. However such care can often support families better and help them make tough decisions as well.

Mitchell and her co-authors are now coming up with better tools to assess life expectancies. In a new method called Advanced Dementia Prognostic Tool, 12 items including body mass index, ability to perform tasks of daily living like self-feeding, bowel incontinence, shortness of breath and oral food intake are analyzed to make the assessment.

Mitchell said that the tool is known to have been accurate in predicting life expectancies of fewer than six months 67 per cent of the time, versus 55 per cent for the Medicare guidelines.

"While ADEPT was better than the Medicare criteria, its predictive ability isn't perfect," said Mitchell. "The delivery of palliative care should be guided by a preference of comfort care rather than by life expectancy," she added.

Dr. Joseph Shega, an associate professor in the section of geriatrics and palliative medicine at the University of Chicago Medical Center, also agrees dementia patients require such care.