This article reports the development of a small pilot program and briefly describes its activities. The growing number of dementia patients in American communities indicates a need to extend hospice services to these patients and their families. It is difficult to determine at present whether this need could be met more effectively by encouraging existing hospices to accept these patients or by establishing specialized programs such as this one. Research in this area is indicated, as well as the sharing of information among hospices providing care to other specialized groups--people with AIDS or terminally ill children for example. The Alzheimer's Family Care Hospice has provided services to eight terminally ill dementia patients and their families in a pilot project sponsored jointly by the Rush Alzheimer's Disease Center and the Chicago Area Chapter of the Alzheimer's Association. Another six patients did not meet admission criteria.

Manyfamilies ofterminally ill dementiapatients may wish to carefor their relatives at home until death occurs either because theyfeel strongly that home is the most appropriate setting or in response to a past promise. Until recently, this had been difficult to accomplish because caring for patients with dementia is a demanding, time-consuming andfrustrating task that can pose a tremendous threat to the welfare andhappiness ofthe caregivers so that they eventually become secondary victims ofthe illness, and eventually seek institutional carefor their relatives.A hospice home care program provides thepractical help and emotional support that caregivers need in order to cope more effectively with the care and eventual death oftheir loved ones at home. This article describes the development and activities of the Alzheimer's Family Care Hospice, a pilotprogram sponsored by the Rush Alzheimer's Disease Center, and the Chicago area chapter oftheAlzheimer's Association. This program has provided services to a total of nine terminally ill dementia patients and theirfamilies during the past ten months. Severe dementiaAccording to the Office of Technology Assessment, an estimated 1.5 million Americans suffer from severe dementia. This number is expected to reach 2.4 million by the year 2000 unless cues or means of prevention are found for the common causes of dementia.' The highest rate of dementia is in the population over age 75, which is the age group that is increasing at the fastest rate. Even if the percentage of those affected by severe dementia remains constant, the size of the affected cohort will be immense by the turn of the century.Generalized seizures are seen in perhaps as many as 10 percent of late stage AD patients.The best estimate of the prevalence of dementia in a specific population was reported in a Finnish study which showed an incidence of 6.7 percent for the group aged 65 and over and 17.3 percent at 85 and over.2 A survey conducted in a California retirement community found a prevalence of dementia of 15.3 percent for the over 65 population and 35.8 percent for the over 80 population.3

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