MYLOGO
Criteria
ALS
- Significant decline in function
- Rapid progression of ALS
- Affected respiratory status
- Secondary conditions such as weight loss or recurrent infections
Liver Disease
- PT>5 over control or INR >1.5
- Serum albumin <2.5
- Secondary conditions such as jaundice and/or ascites; peritonitis; hepatorenal syndrome; hepatic encephalopathy; or recurrent variceal bleeding
Renal Disease
- Patient is not seeking the initiation of dialysis
- Creatinine clearance <10cc/min
- Serum creatinine >8.0mg/dl
- Not a candidate for transplant
Heart Disease
- Patient is symptomatic despite maximum medical management with diuretics and vasodilators
- Shortness of breath with minimal activity
- Significant symptoms of recurrent CHF at rest
Neurological Disease
(Alzheimer's/Dementia)
(Alzheimer's/Dementia)
- Ability to pronounce/articulate words is limited to 1-5 words/day
- Comorbid or secondary conditions
- Weight loss during the last six months
Stroke
- Unable to bathe/dress without assistance
- Weight loss
- Serum albumin <2.5gm/dl
- Current history of pulmonary aspiration
- Food and fluid intake is reduced
HIV/AIDS
- CD4+ count <25 or viral load > 100,000
- Not responding to treatment
- Weight loss
- Comorbid conditions
- Decreased performance status
Pulmonary Disease
- Disabling dyspnea at rest
- Increased hospitalizations or ER visits
- Unintentional weight loss
- Progression of end-stage pulmonary disease
- Hypoxemia on room air
- Hypercapnia
If your patient does not meet these guidelines but is still thought to be appropriate for hospice (i.e. has comorbidities or a recent rapid decline), please call us for an assessment.