By Eric Shaban, MD, Regional Medical Director, VITAS Healthcare
The Palliative Performance Scale (PPS)1 can inform decisions about a patient’s hospice eligibility by helping clinicians recognize a patient's functional decline.
For oncology patients, a PPS score of 70% or below may indicate hospice eligibility.
For most other disease types, a patient with a PPS score of 50% or below may be hospice-eligible. A general way to determine this is to ask yourself: “Does the patient with advanced illness spend more than 50% of their waking hours resting (sitting and lying)?”
| PPS Rating | Ambulation | Self-Care | Intake | LOC | Activity | Evidence of Disease |
|---|---|---|---|---|---|---|
| 100 | Full | Full | Normal | Full | Normal | No evidence of disease |
| 90 | Full | Full | Normal | Full | Normal | Some evidence of disease |
| 80 | Full | Full | Normal or reduced | Full | Normal with effort | Some evidence of disease |
| 70 | Reduced | Full | Normal or reduced | Full | Unable to do normal work | Some evidence of disease |
| 60 | Reduced | Occasional Assistance | Normal or reduced | Full or confusion | Unable to do hobby/housework | Significant disease |
| 50 | Mainly Sit/Lie | Considerable Assistance | Normal or reduced | Full or confusion | Unable to do any work | Extensive disease |
| 40 | Mainly in bed | Complete Assistance | Normal or reduced | Full, drowsy, or confusion | Unable to do any work | Extensive disease |
| 30 | Bed Confined | Total Care | Reduced | Full, drowsy, or confusion | Unable to do any work | Extensive disease |
| 20 | Bed Confined | Total Care | Minimal sips | Full, drowsy, or confusion | Unable to do any work | Extensive disease |
| 10 | Bed Confined | Total Care | Monthly care only | Drowsy or coma | Unable to do any work | Extensive disease |
VITAS also uses the PPS to assess patients’ functional status and collaboratively establish palliative care plans. We provide palliative solutions for a hospice-eligible patient’s symptoms, including pain and other physical, psychosocial and spiritual symptoms.
All interventions focus on enhancing the patient's overall comfort and quality of life near the end of life.
The VITAS app features an interactive PPS calculator. Download now.
1Source: Anderson F, Downing GM, Hill J, et al: PPS: A new tool. J Palliative Care 12(1):5, 1996.