How Do I Know?
What is the patient’s disease and current condition?
The National Hospice and Palliative Care Organization (NHPCO) estimates that the most common disease and conditions associated with hospice care are:
- Cancer (28%)
- Cardiac and circulatory diseases (19%)
- Dementia/Alzheimer’s (17%)
- Respiratory diseases (11%)
- Stroke (9%)
Other conditions include end-stage liver and kidney disease, amyotrophic lateral sclerosis (ALS, or Lou Gehrig’s disease) and other degenerative neurological diseases.
Is the patient showing any of these signs of decline?
- A doctor has certified the patient has six months or less to live if the condition/disease follows its normal course
- Curative treatments (medications, chemotherapy, rehab, etc.) are no longer effective or create side effects that prolong suffering, discomfort, and pain
- The patient has decided to stop testing, hospitalizations, and treatments in favor of palliative care
- The patient is increasingly unable to perform the activities of daily living (personal hygiene, dressing, eating, maintaining continence, transferring)
- Over 4–6 months, the patient has experienced any of these:
- Loss of 10% or more of body weight
- More than 3 hospitalizations or emergency room visits
- Presence of other co-morbid conditions
- Declining physical activity
- Declining mental alertness/cognition
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