Cancer

• Patient and family desire palliative approach to care
• Pain/symptoms poorly coontrolled requiring RN assessment and management at home
• May be receiving palliative XRT and CMT

Alzheimer's/End Stage Dementia

• Patient severly demented
• At or beyond stage 7 of FAST (functional scale)
• One or more of the following in the past year: aspiration pneumonia, UTI, septicemia, decubitus ulcers (3 or 4), fevers with ATB, inability or unwillingness to take food/fluid

Failure to Thrive

• Recent decline in FAST
• Karnofsky less than 40
• Impaired nutrition
• Progressive weight loss
• Co-morbid conditions affecting prognosis

Heart Disease

• CHF S/S at rest
• On optimal diuretic/vasodilator therapy
• Ejection fraction less than 20%
• NY Heart Class IV

HIV Disease

• CD4 + count < 25 cells / mc/ L or viral load > 100,000
• Opportunistic infections
• Stoppage of antiretrovirals, CMT or prophylactic drug therapy

Liver Disease

• Not a liver transplant candidate
• Prothrombin time 5 seconds over control, or INR > 1.5 serum albumin < 2.5 gm/dl

Pulmonary Disease

• Severe lung disease
• Poor response to bronchodilators, dyspnea at rest
• Resting Tachycardia
• O2 Sat less than or equal to 88

ALS

• Rapid progression of ALS symptoms
• Impaired ventilatory capacity
• Nutritional impairment
• Life-threatening complications (ex. aspiration pneumonia, decubitus ulcers, UTIs, recurrent ATB therapy

Stroke/Coma

• Post stroke dementia
• Greater than or equal 10% weight loss during previous 6 months
• Poor functional status with karnofsky of less than or equal to 40

End Stage Renal

• Not seeking dialysis or transplant
• Creatinine clearance < 10 cc/min
• Serum creatinine > 8.0 mg/dl

Unspecified Debility

• Stage 7 of FAST (functional scale)
• At least one major organ deficiency
• Progressive weight loss

To make a referral to Hospice of Charleston, call (843) 529-3100.

Hospice Center Admission Criteria