Hospice care focuses on providing comfort, dignity, and support to patients and their families during the final stages of life. Many patients with advanced illnesses would benefit from hospice care if referred sooner.
Research highlights that early enrollment in hospice improves patient and family satisfaction, reduces healthcare costs, and decreases emergency visits. However, only 7% of eligible patients are referred for hospice at an optimal time.
Don’t wait to refer hospice-eligible patients—ensure they receive the care they deserve.
General Hospice Eligibility Criteria
A patient may qualify for hospice if they meet two or more of the following criteria:
- Dependence on 2–3 of 6 Activities of Daily Living (ADLs)
- Shortness of breath (SOB) or fatigue at rest or minimal exertion
- 10% weight loss in the last 6 months
- Multiple emergency department visits or hospitalizations
- Recurrent falls with injuries
- Decreased tolerance for physical activity
Diagnosis-Specific Hospice Eligibility Guidelines
- Dementia/Alzheimer’s Disease
- Dependent on 3/6 ADLs
- One or more complications, including:
- Pneumonia
- Recurrent UTIs
- Sepsis
- Weight loss (>10%)
- Stage 3 or 4 pressure ulcers
- Feeding tube decision
- Delirium
- Lung Disease
- Dyspnea at rest or minimal exertion while on oxygen therapy
- Disease progression, such as:
- Frequent hospitalizations
- Cor pulmonale
- Cancer
- Spending 50% of waking hours in bed or a chair
- No longer pursuing curative treatments
- Heart Disease
- NYHA Class III or IV (fatigue, angina, or dyspnea at rest/minimal exertion)
- Multiple hospitalizations
- Not a candidate for surgery
- Liver Disease
- INR > 1.5 and serum albumin < 2.5 g/dL
- Complications, including:
- Recurrent ascites
- Hepatic encephalopathy
- Variceal bleeding
- Weight loss (>10%)
- COPD (Pulmonary Disease)
- Dyspnea at rest
- FEV1 < 30% post-bronchodilators
- Recurrent infections or cor pulmonale
- Oxygen saturation ≤ 88% despite oxygen therapy
- Renal Disease
- Creatinine clearance < 10 cc/min (<15 cc/min in diabetics)
- Signs of uremia, including confusion or restlessness
- No dialysis or transplant plan
- HIV/AIDS
- CD4+ count < 25 cells/mm³ or viral load > 100,000 copies/mL
- Complications such as AIDS dementia or CNS/systemic lymphoma
- Decision to forgo antiretroviral or chemotherapeutic treatments
- Functional Assessment Staging for Dementia (FAST)
Hospice eligibility for dementia patients can also be assessed using the FAST scale:- Stage 6: Needs assistance with bathing, dressing, or toileting
- Stage 7: Loss of speech, mobility, or ability to hold head up independently
- Benefits of Early Hospice Referral
- Enhanced Quality of Life: Patients experience greater comfort with symptom management and emotional support.
- Reduced Costs: Patients referred earlier consume an average of $23,600 less in healthcare costs.
- Decreased Emergency Visits: Hospice patients with longer lengths of stay are significantly less likely to visit the ED in the last month of life.
Complex Modalities and 24/7 Care
At Orange Hospice, we provide aggressive symptom management, high-acuity care, and an expanded team of specialists to meet the needs of hospice-eligible patients.
Refer a Patient or Learn More
If you or a loved one may qualify for hospice care, don’t wait to explore your options. Our compassionate team is here to guide you every step of the way.
Call us today at (714) 790-0594 to speak with our hospice care specialists.
