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Using the PPS Tool, VITAS Collaborates on Your Patient’s Palliative Care Plan

Refer your seriously ill patient to hospice: Online | Mobile app | 1.800.938.4827

VITAS provides aggressive treatment of all the hospice-appropriate 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.

Palliative Performance Scale (PPS)

VITAS uses the Palliative Performance Scale (PPS) tool to assess patients’ functional status and collaboratively establish palliative care plans.

PPS Scale
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 +
0 Death 0 0 0 0 0 +

Anderson F, Downing GM, Hill J, et al: PPS: A new tool. J Palliative Care 12(1):5, 1996

What are the most frequent symptoms that VITAS helps manage?

  • Pain
  • Anorexia
  • Dyspnea
  • Nausea/vomiting
  • Profound weakness
  • Dysphagia
  • Bowel obstruction
  • Multi-system deterioration

Therapies Play a Limited Role

With the focus on symptom management rather than treatment of the primary disease, there is a limited role for many traditional disease-modifying therapies, such as:

  • Chemotherapy
  • Radiation therapy
  • Surgery
  • Blood transfusions
  • Total parenteral nutrition (TPN)
  • Parenteral hydration
  • Enteral feedings

When a VITAS patient receives one of these complex modalities, it is because the VITAS physician and interdisciplinary team, the attending physician and the patient and family all agree that:

  • The primary goal of the therapy is to manage one or more symptoms.
  • The therapy has a high probability of being effective in relieving the symptom(s).
  • The benefits of the therapy outweigh any potential side-effects of the therapy.
  • The patient is expected to live long enough to benefit from the therapy.
  • The patient agrees to therapy.

For more information about pallIative care plans, including complex modalities appropriate to your VITAS-referred patient, call 800.938.4827.