When is it time to consider hospice care? 

It depends on each patient’s unique situation and symptoms, but here are some guidelines:

CANCER

  • Clinical finding of malignancy with 
    widespread, aggressive or metastatic disease 

  • Patient no longer seeking curative treatment 

  • Recent labs or diagnostic studies support 
    disease progression 

PULMONARY DISEASE

  • Decreased functional capacity 

  • Evidence of disabling dyspnea at rest or with minimal exertion 

  • Poor response to bronchodilators 

  • Progression of disease as evidenced by increasing visits to physician, ER, or hospital for pulmonary infections 

  • Hypoxemia on room air less than 88 percent by pulse oximetry 

  • Presence of Cor Pulmonale or Right Heart 

  • Failure (ejection fraction less than 25 percent) 

  • An FEV1 pulmonary function test less than 
    30 percent 

RENAL FAILURE

  • Patient is not seeking dialysis or not a candidate for dialysis

  • Creatinine clearance less than 10cc/min

(<15cc/min for diabetics)

  • Serum creatinine greater 8.0mg/dl

(>6.0mg/dl for diabetics)

LIVER DISEASE

  • PT prolonged more than five seconds over control or INR greater than 1.5

  • Serum albumin less than 2.5gm/dl

  • One of the following:

– Ascites

– Hepatic encephalopathy

– History of recurrent variceal bleeding

– Spontaneous bacterial peritonitis

– Hepatorenal Syndrome

NEUROLOGICAL DISEASE 

  • Inability to ambulate, bathe, or dress without assistance 

  • Urinary and/or fecal incontinence (intermittent or constant) 

  • No consistent meaningful verbal communication 

  • One of the following in the last 12 months: 

– Aspiration pneumonia 

– Recurrent UTI 

– Septicemia 

– Decubitus ulcers, multiple stages 3-4 

– Inability to maintain sufficient fluid and calorie intake (weight loss of 10 lbs in a six-month period) 

– Fever, recurrent after antibiotic 

HEART DISEASE 

  • Poor response to optimal treatments with diuretics, vasodilators, or ace inhibitors 

  • Not a candidate for, or has declined, 
    revascularization procedures 

  • Presence of Class IV CHF or refractory angina (ejection fraction less than 25 percent) 

PARKINSON’S DISEASE

  • Critical nutritional impairment

  • Rapid disease progression or complications in the preceding 12 months

  • Inability to ambulate, bathe, or dress without assistance

  • Urinary and/or fecal incontinence (intermittent or constant)

  • Difficulty swallowing food or medications.

CONTACT US

 

T. 405-562-1211

F. 405-562-1210

E. info@centennialhospice.com

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Our mission is to ensure comfort and empathetic care to patients and families who are facing a life-limiting illness. We are dedicated to helping them celebrate life's journey with dignity and respect.

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