Hospice Eligibility, Advance Care Planning

When to Refer a Patient to Hospice

January 10, 2020

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Health care specialists are sometimes uncertain whether their patient may be eligible for hospice services. VITAS offers several solutions to help clinicians better recognize when a patient has transitioned to this phase of life.

Related: How to Have a Goals of Care Conversation With Your Patient

In general, hospice should be considered with any of the following:

  • When symptoms arise secondary to the diagnosis
  • When a patient’s disease continues to progress or when the a patient stops responding to disease-modifying treatments

Additional insights into hospice eligibility can be found on our hospice guidelines, which include general and disease-specific guidance.

In general, look for these signs over the last 4-6 months:

  • The illness, if it progresses as expected, has a prognosis of six months or less. (Ask yourself: “Would I be surprised to learn, six months from now, that this patient has died?” If your answer is no, request a hospice evaluation for this patient.)
  • Patient has a PPS rating of < 50%-60%
  • Patient is dependent in any 3 out of 6 ADLs
  • Patient has lost more than 10% body weight, or another alteration in nutritional status
  • Patient has had 3 or more hospital/ED visits
  • Decrease in physical activity
  • Decrease in cognitive ability 

An interactive Palliative Performance Scale, which represents a strong predictor of hospice eligibility, can be found on our award-winning app; download it from the Apple App Store and Google Play.

Lastly, health care professionals can enhance their understanding of hospice including eligibility through our webinars and in-person trainings.