When to make a hospice referral

These guidelines will help identify residents/patients with non-cancer diagnosis who may be eligible for hospice services. They are guidelines only. If you think someone could benefit from hospice services, please call.

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Dementia/Alzheimer’s and Failure to Thrive

• Spends most of time in bed or chair

• Requires assistance with most ADL’s

• Incontinent of Bowel and/or bladder

• Unable to speak more than 7 words daily

• Co-morbid conditions such as:

  • Pressure Ulcers

  • Recurrent infections

  • Serum Albumin <2.5 gm/dl

  • Significant weight loss or BMI <22

 

Renal Disease

• Not seeking dialysis

• Elevated BUN and creatinine

• Creatinine clearance or GFR <10ml/minute

  • (<15ml//min with diabetes

• Urine Output of <400ml/day

• Cachexia or massive edema

 

Liver Disease

• Pt >5 seconds above control or INR >1.5

• Serum albumin >/= 2.5 gm/dl

• At least one of the following:

  • Elevated BUN and creatinine w/decreased urinary output

  • Ascites

  • Spontaneous bacterial peritonitis

  • Hepatic encephalopathy

  • Recurrent  variceal bleeding

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