Results provide a formula which can be used to predict likelihood of dying within 6 months following onset of a fever in DAT patients. This statistical prediction is recommended for use in combination with clinical judgment to certify DAT patients for Medicare hospice coverage.

A gradual deterioration of mental and physical condition is one of the main clinical signs of dementia of the Alzheimer type (DA T). To describe this deterioration, we evaluated 88 institutionalized patients with DA T and plotted their current status on a number of different clinical parameters as a function of time from the estimated onset of dementia. Ratings of speech, cooperation, social contact, and communication were in the very low range in patients with duration of DA T of three years or longer, while the rating of mood was similar regardless of duration of DA T. Half of the patients were unable to dress themselvesfive years after onset of symptoms and unable to sleep regularly six years after onset. By seven years 50% had developed rigidity on passive movement, and by eight years half were unable to feed themselves and to walk without assistance. By nine to ten years, 50% had developed contractures of the limbs and were mute, and by twelve years, half of those who survived had lost eye contact with caregivers.AUTHORS' NOTE: This study was supported by the Veterans Administration. We gratefully acknowledge the assistance of Paula Lyon, M.Ed., and members of the nursing staff, in the data collection. Requests for reprints should be sent to Dr.

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Alzheimer's Disease is a devastating, age‐related, irreversible clinical syndrome characterized by a wide spectrum of progressive impairments in cognitive, behavioral and functional abilities. Since no effective therapy exists to cure or arrest the disease progression, treatment efforts are directed at providing relief of the physical, emotional and psychosocial discomforts associated with the advancing illness. Treatment goals focus on promoting quality of life for both patient and family with particular emphasis on role adjustments, comfort and safety. The complexity of changing illness manifestations necessitates professional multidisciplinary collaboration throughout the course of the illness. Continuity of care in the transition from home to institution is of great benefit to the patient, the family and the professional staff. The philosophy of caring and examples of intervention strategies to deal with the distressing symptoms in both the patient and the family are discussed.

A wide-range of respite services have been developed to meet the needs of families who care for the chronically ill and frail elderly. Institutional respite is a particular service that provides inpatient care to patients and offers their families temporary relief from the strain of continuous caregiving. This paper describes a two-week in-hospital respite program specifically designed for patients with Alzheimer's disease. Patients are profiled on the use of respite, sociodemographic characteristics, functional levels, and their dispositional outcome following respite.