End Stage Diseases Common in Hospice

The fact is hospice is for anyone living with a life limiting illness that has a life expectancy of approximately six months or less.

Did you know you can leave hospice at any time for any reason? Consider hospice care early – we think you will be amazed at how much hospice improves the quality of life for those we serve.

General Guidelines that indicate it is time to consider hospice:

  1. A recent decline in functional status/physical decline
    • Multiple falls
    • Increased calls/visits to physician
    • Emergency Department visits
    • Hospitalizations
    • Sleeping more
    • Increase in pain or other symptoms
    • Change in mental status (less alert, more confused, etc.)
  2. Dependence upon others for Activities of Daily Living (ADL).  Needs more help with:
    • Bathing
    • Dressing
    • Using the rest room
    • Eating
  3. Recent decline in nutritional status with unintentional weight loss
  4. Multiple chronic diseases or conditions

Common Hospice Diagnoses & Some of Their Hospice Indicators

  • Curative treatment unlikely to improve quality or length of life
  • Metastasis to multiple sites
Heart Failure
  • Chest pain and/or shortness of breath with and without activity
  • Taking multiple cardiac medications
  • Patient and/or physician believe heart surgery is not a preferred option
Chronic Obstructive Pulmonary Disease (COPD)
  • Shortness of breath at rest and with any activity
  • Recurring respiratory infections
  • Using multiple inhalers with poor response
  • Speaks few intelligible words
  • Needs help to sit up
  • Unable to walk without assistance
  • Difficulty swallowing, unable to take in adequate nutrition
  • No feeding tube (current or planned)
Liver Failure
  • Ascites despite use of diuretics
  • Serum albumin 1.5
Renal Failure
  • Considering stopping dialysis
  • Serum creatinine >8.0 (>6.0 for diabetics)
  • CD4+ count 100,000
  • Secondary conditions(Kaposi’s sarcoma, pneumocystis pneumonia, fungal infections, etc.)
Amyotrophic Lateral Sclerosis (ALS)
  • Barely intelligible speech
  • Significant shortness of breath
  • Difficulty swallowing accompanied by rapid weight loss
  • No feeding tube or ventilator (current or planned)
Hospice should be a timely choice… Not a last resort.

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