GOOD SHEPHERD

Hospice is a special kind of care designed to sensitively provide for people in the final phase of life. We understand that families have questions and concerns about what hospice provides. Our team provides service not only for the patient but for the entire family.
General Hospice Indicators *For admission to hospice, it must be the physician's opinion that the patient has a life expectancy of 6 months or less.* Decubitus ulcers, multiple, especially if infection is present Recent history of frequent hospital stays and ER visits A serum albumin that is less than 2.5 gm/dl Unable or unwilling to take in food and fluids sufficient to sustain life Weight loss that is greater than 10% over last 6 months that was not intentional Over 90 years of age with multiple system co-morbidities
Diagnoses with Indicators
Amyotrophic Lateral Sclerosis (ALS)Rapid progression significant dyspnea at rest/supplemental oxygen required at rest Cancer Patient has failed other treatment and chooses not to try any further therapies or there is evidence of metastatic disease. Cardiac Disease Prior medication therapy has failed. Rales, Edema, Syncope, Tachycardia, or Tachypnea may be seen COPD/Pulmonary Disease Non-response to RX therapy Rales; Gallop rhythm; S3, S4 Edema, pitting edema Syncope/near –syncope Tachypnea at rest Tachycardia at rest CVA/Stoke and Coma CT or MRI findings consistent with terminal diagnosis Cannot sit up without assistance Medical complications related to debility and progressive clinical decline	Debility Unspecified Co-existing morbidities exist which in isolation or in combination lead to clinical determination that life expectance is less than 6 months Dementia Deficient in several ADLs. Inability to speak more than a few meaningful words. Fever, Aspiration pneumonia, Decubitus Ulcers – may also be seen Diabetes Mellitus History of diabetes> 20 years Renal failure Vascular insufficiency (cardiac, cerebral, peripheral, hypertension) Neuropathy, Retinopathy End Stage Neuromuscular Disease MD, MS Parkinson’s Disease, Myasthenia Gravis End Stage Renal Disease Elective discharge of dialysis Hepatorenal syndrome Intractable fluid overload	HIV Disease Patient has elected to forgo antiretroviral and prophylactic medication Experiencing complications Liver Disease Hepatorenal syndrome Stupor (late stage) Obtundation Hepatocellular Carcinoma Pulmonary Disease Prior medication therapies have now failed. Cyanosis, wheezing, fatigue may also be present These are just a few of the many diseases and indicators that may be cause for a hospice evaluation. We will be glad to evaluate your patient for you to determine whether or not they are appropriate for hospicecare.

Hospice is a special kind of care designed to sensitively provide for people in the final phase of life. We understand that families have questions and concerns about what hospice provides. Our team provides service not only for the patient but for the entire family.

General Hospice Indicators

For admission to hospice, it must be the physician's opinion that the patient has a life expectancy of 6 months or less.

Decubitus ulcers, multiple, especially if infection is present
Recent history of frequent hospital stays and ER visits
A serum albumin that is less than 2.5 gm/dl
Unable or unwilling to take in food and fluids sufficient to sustain life
Weight loss that is greater than 10% over last 6 months that was not intentional
Over 90 years of age with multiple system co-morbidities

Diagnoses with Indicators

Amyotrophic Lateral Sclerosis (ALS)Rapid progression significant dyspnea at rest/supplemental oxygen required at rest

Cancer
Patient has failed other treatment and chooses not to try any further therapies or there is evidence of metastatic disease.

Cardiac Disease
Prior medication therapy has failed. Rales, Edema, Syncope, Tachycardia, or Tachypnea may be seen

COPD/Pulmonary Disease
Non-response to RX therapy
Rales; Gallop rhythm; S3, S4
Edema, pitting edema
Syncope/near –syncope
Tachypnea at rest
Tachycardia at rest

CVA/Stoke and Coma
CT or MRI findings consistent with terminal diagnosis
Cannot sit up without assistance Medical complications related to debility and progressive clinical decline

Debility Unspecified
Co-existing morbidities exist which in isolation or in combination lead to clinical determination that life expectance is less than 6 months

Dementia
Deficient in several ADLs. Inability to speak more than a few meaningful words. Fever, Aspiration pneumonia, Decubitus Ulcers – may also be seen

Diabetes Mellitus
History of diabetes> 20 years
Renal failure

Vascular insufficiency (cardiac, cerebral, peripheral, hypertension)
Neuropathy, Retinopathy

End Stage Neuromuscular Disease
MD, MS Parkinson’s Disease, Myasthenia Gravis

End Stage Renal Disease
Elective discharge of dialysis
Hepatorenal syndrome
Intractable fluid overload

HIV Disease
Patient has elected to forgo antiretroviral and prophylactic medication
Experiencing complications

Liver Disease
Hepatorenal syndrome
Stupor (late stage)
Obtundation
Hepatocellular Carcinoma

Pulmonary Disease
Prior medication therapies have now failed. Cyanosis, wheezing, fatigue may also be present

These are just a few of the many diseases and indicators that may be cause for a hospice evaluation. We will be glad to evaluate your patient for you to determine whether or not they are appropriate for hospicecare.