Hospice Care for Dementia and Alzheimer’s in Metro Detroit

Updated September 2026. Written and reviewed by the Lily Hospice clinical team.

Yes, advanced dementia or Alzheimer’s qualifies for hospice in Michigan once a physician judges that life expectancy is likely six months or less. Medicare, Michigan Medicaid and most private plans cover it in full, at home or in memory care. Lily Hospice evaluates the same day across Oakland, Macomb and Wayne counties.

In Medicare’s most recent Care Compare data, 71.3% of Lily Hospice patients were visited by a nurse or social worker in their last three days of life, against a national average of 48.3% and a metro Detroit median of 60.9% across the 104 hospices serving Oakland, Macomb and Wayne counties. “Most families tell us afterward that they wish they had called sooner,” says the Lily Hospice clinical team. “The evaluation is free, and the earlier we meet a family, the more good days we can protect.”

Dementia does not end the way most families expect. There is rarely one dramatic moment. Instead there is a slow narrowing: fewer words, then fewer steps, then meals that take an hour and still end with most of the plate untouched. Families in Troy, Sterling Heights and Livonia tell us the hardest part is not knowing whether what they are seeing is “just the disease” or a sign that it is time for more help.

Hospice was built for exactly this stretch. It does not stop dementia, and it does not replace the memory care staff or the daughter who has been doing everything. It adds a nurse who knows what late-stage Alzheimer’s looks like, an aide for bathing and skin care, a social worker for the paperwork and the family conversations, and one phone number that a real person answers at 3 a.m.

Dementia hospice in Michigan: how it works here

The rules are federal, but the help is local. Medicare’s hospice benefit pays any Medicare-certified hospice in Michigan the same way, and the state’s own Hospice Care in Michigan page from MDHHS explains the patient rights that come with it, including the right to choose your hospice. For someone with dementia in a nursing facility on Michigan Medicaid, Medicaid keeps paying room and board while Medicare pays the hospice; see hospice and long-term-care Medicaid in Michigan. The Alzheimer’s Association Michigan Chapter, headquartered in Southfield, runs a 24/7 helpline at 800-272-3900 that many of our families lean on alongside hospice. And because a dementia journey can be long, it helps to know that hospice in Michigan is not a six-month clock: read how long hospice lasts and what happens on the first hospice visit.

Signs it may be time to talk about hospice

Medicare uses a specific staging scale for dementia, and your loved one’s physician makes the final call. But these are the changes families usually notice first:

Needs help with nearly every daily activity: dressing, bathing, using the toilet, walking
Speech has shrunk to a handful of words, or is gone
Can no longer walk without help, or is mostly in bed or a chair
Trouble swallowing, coughing with meals, or refusing food and drink
Weight loss over the past six months without trying
Repeated infections in the last year: pneumonia, urinary infections, infected pressure sores
A hospital or ER visit that did not really change anything
A caregiver who is exhausted, frightened, or both

If several of these feel familiar, it is not too early to ask. Most families tell us later that they wish they had called sooner.

What hospice actually does for someone with dementia

Comfort instead of crisis. Late-stage dementia brings pain that cannot be described in words, agitation in the evenings, and fear during care. Our nurses are trained to read those signs and treat them, so that a bath does not become a battle and nights become calmer for everyone.

Fewer ambulance rides. Every trip to the ER is disorienting for someone with dementia and often makes the confusion worse. With hospice, most fevers, breathing changes and falls are managed where your loved one lives. A nurse comes to you, not the other way around.

Help for the people doing the caring. A hospice aide visits for personal care. Volunteers can sit with your mother so you can get to the pharmacy. Respite care gives a family caregiver a few days to sleep. After a death, bereavement support continues for your family for more than a year.

When eating stops. Late in dementia the body needs and wants less. We help families offer small amounts safely, explain what the change means, and take the pressure off mealtimes; our guide on when a dying person stops eating and drinking answers the questions that keep families up at night. If your parent with early-stage dementia still lives alone, read hospice when your parent lives alone.

Care wherever home is. Many of the families we serve have a parent in memory care in Farmington Hills, West Bloomfield, Shelby Township or Canton. Hospice works inside the community’s routine, adds to what the staff already do, and gives the facility a nurse to call at night.

A note on feeding tubes and hospital transfers

Families are often asked, sometimes in a hallway, whether they want a feeding tube or a transfer to the hospital. For advanced dementia the evidence is that feeding tubes rarely help and often cause harm, and that hospitalization tends to accelerate decline. We will never make that decision for you. We will sit down with you, explain what each choice usually means, and support whatever you decide.

Talk it through with a nurse, day or night

You do not have to decide anything on the phone. Call (248) 955-5100 and a real person answers, 24 hours a day. We can visit for a no-obligation evaluation, usually within a day, and if hospice is not the right fit yet, our Pathways palliative program may be.

Not ready to call? Read Is It Time? A Family’s Gentle Guide to Hospice.

Common questions

Is dementia by itself enough to qualify for hospice?

Yes, when the disease has reached its advanced stage. A physician certifies that life expectancy is likely six months or less if the illness follows its usual course. Advanced dementia, especially with recent weight loss, infections or swallowing problems, often meets that standard. We can do a no-obligation evaluation and tell you honestly where things stand.

My mother is in memory care. Can she stay there and still have hospice?

Yes. Hospice comes to her. We coordinate with the community’s staff, add nursing, aide, social work and chaplain visits, and give the staff a hospice nurse to call around the clock.

What if she lives longer than six months?

Then care continues. Hospice is re-certified as long as your loved one remains eligible. Some people with dementia are on hospice for a year or more; nobody is “discharged for living.”

Does hospice mean we stop all her medications?

No. We keep what adds comfort and gently review what no longer helps, always with you. Many families find the medication list gets shorter and their loved one is calmer for it.

Who pays?

The Medicare hospice benefit covers the hospice team, medications related to the illness, and equipment such as a hospital bed, with little or nothing out of pocket for most families. Medicaid and most private plans have a similar benefit.

Does Medicaid cover hospice for dementia in a Michigan nursing home?

Yes. Michigan Medicaid has a hospice benefit that mirrors Medicare’s. When someone has both, Medicare pays the hospice and Medicaid keeps paying the nursing facility’s room and board, routed through the hospice, so choosing hospice never puts the Medicaid bed at risk.

She has stopped eating. Is that the disease, or the end?

Often both. In advanced dementia the swallowing reflex weakens and appetite fades, and this is one of the signs physicians weigh for hospice eligibility. The hospice nurse shows the family how to offer food and fluids safely and explains what the change means, so nobody has to guess.

Who answers if the memory care staff call at 2 a.m.?

A real person at Lily, 24 hours a day, at (248) 955-5100. A hospice nurse calls back, gives instructions, and comes out when a visit is needed, so the community does not have to send your mother to the emergency room by default. See who answers a hospice phone at night.

Where we come to you

Lily Hospice cares for families at home, in assisted living, memory care and nursing facilities across Oakland County, Macomb County and Wayne County, from our office in Troy. Veterans and their families can read about our veteran-specific hospice care.

General education, not medical advice. Whether hospice is appropriate is a decision made with your loved one’s physician. Medicare hospice eligibility is based on a physician’s judgment that life expectancy is six months or less if the illness runs its usual course; people are not required to stop living past six months, and care can continue as long as they remain eligible.

Hospice isn’t giving up. It’s showing up. Call (248) 955-5100. A real person answers, 24 hours a day.