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My wife has had dementia for a little over five years. I am her caregiver. She cannot control her urine and now her bowels are becoming unpredictable. I help her with all her needs. She feeds herself. I clothe and bathe her and do all the necessary things to maintain a household. She talks very little and spends most of the day listening to oldies stations on the TV. She reads a little. Her mental outlook is very positive.


What signs should I be looking for?

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Contact Hospice today, or tomorrow, whenever you are comfortable doing so.
With Hospice you will get more help as well as supplies, information.
Hospice does not necessarily mean..."6 months" (My Husband was on Hospice for almost 3 years...Alzheimer's and maybe Vascular dementia)
You will have a Nurse that will come at least 1 time a week to check on her and order medications.
You will have a CNA that will come at least 2 times a week, more if needed to bathe, dress, change bedding if needed. The CNA will also order supplies for you, give you information and if equipment is needed to make your job easier and safer the CNA will show you how to use any equipment. While you can do all this yourself, and have been having someone else will give you a break for a few hours.
I would not have been able to care for my Husband the way I did if it had not been for the help and support I got from Hospice.
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All you have to do is contact hospice.. and that is their job.. they will come out and do an assessment and determine if she is eligible. All they have to do is be eligible with a certain health issue.
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I'd get a hospice eval done now. The worst thing they can say is 'she's not ready' And at least you'd be 'in the system' when the time comes.

You're with your wife--you are going to have to be her advocate.

Hospice was a Godsend to us when daddy began the slow decline into the end of his life. It made his passing calm and peaceful, and kept him comfortable. That's what it's there for.
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Hopefully she'll due Peaceful in her sleep.

Before death, she'll talk less.

She'll start sleeping more than being awake.

She'll start eating and drinking less.

One of the last things, she will have what is called the death rattle which is a weird sound with her breathing.

Prayers
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It certainly wouldn't hurt for you to get Hospice involved now. If she doesn't qualify for actual hospice now, she may qualify for their palliative care, and then as time goes on transition into hospice care. My husband has been under hospice care for the last 18 months, so just because someone qualifies for their care doesn't necessarily mean that death is iminent. God bless you for taking such good care of your wife. She is certainly blessed to have you.
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Ask EARLY, More and more it is no longer a matter of the 6 month rule, tho that is still what the doc signs on. You will get more help and more support and in my experience people always sign on way too late. There is no death sentence administered if she is still alive in 6 months and will be signed up again in all likelihood, or be deemed too well. You do understand that care after this sign on is palliative. There will not be working toward "cure" but toward "comfort" and all tests such as mammograms and all that are put to the side. Of course were she to get pneumonia or UTI she would get treated for that as it is "uncomfortable" to suffer symptoms with disease. But there is no working toward diagnosis and cure. That is something you should accept. It is lovely that her symptoms give her a positive mental outlook. If hospice people come it is important that she not be treated as though she has a death sentence of some kind, but rather that the is the way toward getting more and better care and support.
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You should ask for a Hospice evaluation now. The worst that can happen is that they say "no, she doesn't qualify yet". Doing this now as opposed to when your wife is in crisis or actively dying means that you can interview several providers, get feedback from others who have used the particular provider you are looking at and make you decision at your leisure and convenience.

I believe that most of us wait much to long to get Hospice involved. They can offer comfort, 24/7 phone advice and can help avoid unnecessary ER visits and hospitalizations.
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