Hospice Eligibility Criteria

Heart Disease

Inability to engage in physical activity without symptoms of heart failure such as dyspnea and chest pain; poor response or decision to forgo diuretics and vasodilator treatments; increased oxygen needs; syncope; changes in mental status; increased fatigue.

Liver Disease

PT over 5 seconds; INR greater than 1.5; Albumin less than 2.5g/dL; and any of the following: Ascites, spontaneous bacterial peritonitis; hepatorenal syndrome; hepatic encephalopathy; recurrent variceal bleeding.

Renal Failure

Not seeking dialysis or renal transplant; Creatinine clearance <10cc/min or <15cc/min for diabetics); serum creatinine >8.0mg/dl (>6.0mg/dl for diabetics).

Cancer

Malignancy with metastasis or progressive disease despite treatments in addition to functional decline or weight loss.

Stroke or Coma

Dysphasia and unable to maintain sufficient intake of nutrients to sustain life; Coma with three of the following beyond 3 days duration: Abnormal brain stem response, absent verbal response, absent withdrawal response from pain, serum creatinine &gt;1.5mg/ml

HIV/AIDS

CD4 count less than 25 or persistent viral load greater than 100,000 copies/ml plus one of the following: CNS lymphoma, loss of 33% lean body mass, progressive multifocal leukoencephalopathy, systemic lymphoma, Visceral Kaposi’s sarcoma, renal failure, Cryptosporidium infection, toxoplasmosis

Dementia

Ability to speak limited to 6 intelligible words or less; inability to walk without assistance; new or worsening incontinence; inability to sit without support; and in the last 12 months has experienced one or more of the following: Aspiration pneumonia, pyelonephritis or other upper urinary tract infection, sepsis, stage 3-4 decubitus ulcers, 10% weight loss, or fever recurrent after antibiotics.

Pulmonary Disease

Disabling dyspnea at rest; poor response to bronchodilators; bed to chair existence; fatigue; cough; hypoxia at rest or oxygen saturation & lt;88% on room air; increasing physician’s office, ER visits and/or hospitalizations for pulmonary infections or respiratory failure.

Parkinson’s Disease

Progression to dependence in 3 or more ADLs; mostly bed bound; increasing dysphagia; dystonia; dysarthria; incontinence; decreased cognitive abilities; increased hallucinations or fixed delusions.

ALS

Critically impaired breathing with dyspnea at rest requiring O2 and patient declines artificial ventilation, or rapid disease progression and nutritional impairment.

Possibly Indicators of General (Non - Specific) Terminal Illness:

  • Patient diagnosed with a terminal illness with a life expectancy of 6 months or less

  • Patient and family wish to focus on comfort rather than cure

  • Increasing hospitalizations or ER visits

  • Recurrent infection

  • Decline in functional status or requiring more assistance with activities of daily living

  • Weight loss in the last 3-6 months

  • Difficulty swallowing

  • Increased pain

  • Increased shortness of breath

  • Changes to mental status or increased confusion or forget fulness

  • Increased falls, with or without injury

  • Unhealed wounds, including stage 3-4 pressure ulcers

  • Increased edema

  • Unresolved psychosocial needs or spiritual issues