GENERAL GUIDELINES FOR
ADMISSION
General Criteria for
cancer diagnosis and other disease
Life-limiting condition
with prognosis of six months or less if disease progression runs its normal
course
Patient/Family informed
that condition is life-limiting and have elected comfort/palliative care instead
of curative care.
Signs that disease
process is progressing
- Frequent
hospitalizations
- Progressive weight
loss (taking into consideration swelling)
- Increasing weakness
- Fatigue
- Sleeping more
- Confusion
- Weakness, unable to
help self, Deteriorating mental abilities
- Frequent infections,
Skin breakdown
- Specific decline in
condition
Specific symptoms for
various diagnoses.
PULMONARY DISEASE
- Symptomatic at
rest: fast breathing, shortness of breath, fast heart rate.
- Oxygen dependent
- Fluid in the lungs,
Increased shortness of breath upon exertion (change from prior level of
function) Increasing blueness of lips and hands, Progressive cough
- Anxiety
- Unintentional weight
loss
CARDIAC DISEASE
- Signs & symptoms of
CHF at rest; shortness of breath, sweating, skin and bones, moist lungs,
alteration in heart sounds, enlarged liver, edema, sporadic nighttime
shortness of breath, Weakness
- Frequent medication
adjustments
- Shortness of breath
lying down, dizziness
- Increasing chest
pain – duration and/or frequency
- Pale or ashen skin
color
- Increased symptoms
- Ejection fraction
<20% (only if test results available)
NEUROLOGICAL DISEASE
- General signs and
symptoms of some neurological conditions/diseases including but not limited
to Alzheimer’s, other dementias, Parkinson’s, Multiple Sclerosis,
Amyotrophic Lateral Sclerosis (ALS), and Huntington’s disease:
- Increased weakness,
unable to care for self,
- Signs of bulbar
involvement: increased trouble swallowing, talking, breathing
- Difficulty or
inability to speak,
- Nutritional
impairment with current episodes of aspiration pneumonia, Weight loss
ALZHEIMER’S DISEASE
- Limited intelligible
speech or inability to speak
- Inability to
ambulate or sit up independently
- Unable to smile
- Social Isolation
- Repeated infections
- Progressive weight
loss, unable to swallow effectively Low protein and serum albumin levels
- Difficulty or
inability to hold head up independently
- Score of three or
less on Mini Mental State Exam
- Skin breakdown
Urinary and bowel incontinence
AIDS CRITERIA
- Must have
established AIDS diagnosis
- Decision has been
made to forego antiretroviral, antibacterial, antifungal, chemotherapeutic
and prophylactic drug therapy related specifically to the AIDS diagnosis
- Chronic, persistent
diarrhea,
- Significant weight
loss of 10% or more in past three months *Generalized weakness
- Persistent serum
albumin <2.5, Viral load >100,000 copies ml, CD4 count <50
- History of frequent
opportunistic infections
LIVER DISEASE
- Not a candidate/does
not desire liver transplantation resection
- Enlarged liver
Jaundice
- Abdominal Swelling
- Malnutrition, Muscle
wasting
- Weakness and unable
to care for self
- Decreased urination
- Recurrent variceal
hemorrhage (vomiting blood)
RENAL DISEASE
- Creatinine clearance
of <10cc/mn (<15cc/min for diabetics AND serum creatinine >8.0 mg/dl
(>6.0mg/dl for diabetics)
- Uremia
- Nausea/vomiting,
itching, Restlessness
- Urine output of <400
cc/24 hours
- Uncorrectable fluid
overload
- Uncorrectable
potassium level >7.0 mEq/L
- Uremic pericarditis,
Hepatorenal syndrome
- Patient has chosen
not to have renal dialysis
STROKE
- Recurrent
infections, Recurrent ministrokes
- Poor nutritional
status
- Skin breakdown,
paralysis, Post stroke dementia
- Age typically >70
years
·
Comatose
with any four of the following on Day 3 indicate poor long term survival (97%
mortality rate within two months): Abnormal brain stem response, Withdrawal
response to pain is absent Age >70 years Verbal response absent
Serum creatinine
>1.5mg/dl
If you or a loved one would like more
information on Hospice and/or Hospice services please feel free to call
1-800-328-5446 or 1-660-890-2014