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Eligibility
A person qualifies for hospice care if:
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2 doctors- typically the hospice doctor and the person's attending physician- certifies that the patient has a terminal illness with a life expectancy of 6 months or less to live. This certification for hospice may be extended when needed.
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the person accepts palliative care, or comfort care, over curative care
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the person or a surrogate, such as their medical power of attorney, signs a formal hospice benefit election
Physicians look at disease specific guidelines for hospice eligibility. The common hospice diagnoses includes: amyotrophic lateral sclerosis (ALS), Alzheimer's and Dementia, COPD, Heart disease, HIV and AIDS, Liver Disease (i.e. hepatic failure), Neurological Disease (i.e. stroke, coma, multiple sclerosis, Parkinson's disease, Renal Failure, and Cancer.
Physician's also consider the following:
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The patient has a declining functional status as determined by either:
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Palliative Performance Scale (PPS) rating of ≤ 50%-60%
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Increasing dependence in Activities of Daily Living (i.e. feeding, dressing, bathing, toileting, transferring, ambulating, )
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The patient has alteration in nutritional status, e.g., > 10% loss of body weight over last 4-6 months
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The patient has an observable and documented deterioration in overall clinical condition in the past 4-6 months, as manifested by at least one of the following:
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≥ 3 hospitalizations or ED visits
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Increased falls
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Increased infections
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Decrease in tolerance to physical activity
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Decrease in cognitive ability
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Other medical conditions/ co-morbidities
Note: These guidelines provided are a convenient tool and not used as a replacement for a physician’s professional judgment.