A Comprehensive Breakdown of the Clinical Signs for When Hospice Care is Appropriate
Hospice care is a holistic approach to treatment that focuses on the patient and family which addresses the physical, mental, emotional, and spiritual needs of the patient and family.
At Connecticut Hospice, we understand that it is a highly personal decision to begin receiving hospice care and we value the choices and goals of each patient and family. We are here to help you make the decision of when it's time for hospice care.
Centers for Medicare and Medicaid Services, 2021
The patient is unable to be weighed on scales due to bed-bound status. MAC is 18cm to the right upper arm. During the interview with the daughter, who has been caring for the patient over the past year, she said that her mother has lost weight in the past 3 months but unable to state how much. The daughter states that she has been wearing clothing in a size 16 women’s but now she had to get mother new clothing gradually over the past few months due to her clothing “falling off of her”. The patient is now able to wear size 10 women's clothing.
The patient has been eating 4-6 child-size meals per day but has only eaten about 25% of each meal. This consists of 2 slices of bacon, 3 bits of grits for breakfast. She had a 1/3 of an Ensure supplement, then for lunch, she had a few bites of homemade soup and a popsicle.
The patient requires assistance of one for bathing at the sink, dressing his lower body and now uses a walker for all ambulation inside and outside of his room. The patient was completely independent with all ADL’s and driving and working every day until 3 months ago when he was diagnosed.
The Nurses Aide describes the patient is sleeping 8-10 hours at night and then takes a 3-4 hour nap during the day. When the patient is up in the chair for more than an hour, she is frequently dosing off. This is a change from just 2 months ago when the patient was not even sleeping during the night and was having agitation in the evening and sleeping a few hours during the day only
(HIV Disease, Stroke, and Coma require a lower score to qualify)
|%||Ambulation||Activity Level Evidence of Disease||Self Care||Intake||Level of Consciousness||Est. Median Survival in Days (a)||Est. Median Survival in Days (b)||Est. Median Survival in Days (c)|
|100||Full||Normal No Disease||Full||Normal||Full||NA||NA||108|
|90||Full||Normal Some Disease||Full||Normal||Full||NA||NA||108|
|80||Full||Normal With Some Effort Some Disease||Full||Normal||Full||NA||NA||108|
|70||Reduced||Can't do Normal Job or Work Some Disease||Full||Normal or Reduced||Full||145||NA||108|
|60||Reduced||Can't do hobbies or housework Significant Disease||Occasional assistance needed||Normal or Reduced||Full or Confusion||29||4||108|
|50||Mainly sit/lie||Can't do any work Extensive Disease||Considerable assistance needed||Normal or Reduced||Full or Confusion||30||11||41|
|40||Mainly in bed||Can't do any work Extensive Disease||Mainly assistance needed||Normal or Reduced||Full or Drowsy or Confusion||18||8||41|
|30||Bed Bound||Can't do any work Extensive Disease||Total Care||Reduced||Full or Drowsy or Confusion||8||5||41|
|20||Bed Bound||Can't do any work Extensive Disease||Total Care||Minimal||Full or Drowsy or Confusion||4||2||6|
|10||Bed Bound||Can't do any work Extensive Disease||Total Care||Mouth Care Only||Drowsy or Coma||1||1||6|
|100||Normal no complaints; no evidence of disease|
|Able to carry on normal work; no special care needed||90||Able to carry on normal activity; minor signs or symptoms of disease|
|80||Normal activity with effort; some signs or symptoms of disease;|
|70||Cares for self; unable to carry on normal activity or do active work.|
|Unable to work; able to live at home and care for most personal needs; varying amount of sassistance needed.||60||Requires occasional assistance; but is abke to care for most personal needs.|
|50||Requires considerable assistance and frequent medical care.|
|40||Disabled; requires special care an assistance.|
|30||Severely disabled; hospital admission necessary; active supportive treatment necessary.|
|Unable to care for self; requires equivalent of institutional or hospital care; disease may be progressing rapidly.||20||Very Sick; hospital admission necessary; active support treatment necessary.|
|10||Moribund; fatal processes progressing rapidly.|