How to use
- The certification of terminal illness of an individual who elects hospice shall be based on the physician's or medical director's clinical judgment regarding the normal course of the individual's illness.
- Find the diagnosis that matches that of the patient.
- Check indicators under the diagnosis. If the patient matches ANY of the
- criteria listed (unless otherwise stated), a referral may be made to Share Medical Center Hospice for a hospice care consultation.
Facts for physicians and healthcare professionals
- Other indicators to consider when looking at a hospice referral are:
- Progressive disease with increasing symptoms and/or worsening lab values and/or decreasing functional status and/or evidence of metastatic disease, particularly brain.
- Stage IV at initial diagnosis; Stage III with pleural effusion; or Stage II with patient continuing to decline despite definitive therapy
- Karnofsky Performance Status < 70 or Palliative Performance Score < 70%
- Symptomology:
- Pain
- Dyspnea
- Significant hemoptysis
- Superior vena cava syndrome
- Lymphangitic lung involvement
- Recurrent pneumonia (two or more episodes in three months)
- Laboratory abnormalities:
- LDH > twice normal
- Albumen < 2.5
- Calcium > 14
- Weight loss of five percent or more in the last three months due to progressive disease, or irreversible dysphagia or loss of appetite;
- Presence of severe co-morbidities that contribute to a life expectancy of six months or less, including but not limited to:
- Chronic obstructive pulmonary disease
- Congestive heart failure
- Diabetes mellitus
- Neurologic disease (CVA, ALS, MS)
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