Hospice, Inc.

Metropolitan

    
Guide to Eligibility  Diagnoses   Q & A
Non - specific Terminal Illness
© 2004 Metropolitan Hospice Inc. All rights reserved

The patient has a terminal medical condition that cannot be attributed to a single specific illness. The physician believes there is a limited diagnosis of six months or less based on a constellation of signs, symptoms, test results and/or clinical decline.

The clinical impression of six months or less is based on the following:

  1. Rapid decline over the past 3-6 months evidenced by:
    1. Progression of disease evidenced by symptoms, signs and test results
    2. Decline in Palliative Performance Scale
    3. Weight loss not due to reversible causes and/or declining serum albumin levels
    4. Dependence on assistance for two or more ADLs: feeding, ambulation, continence, transfer, bathing, dressing

  2. Dysphagia leading to inadequate nutritional intake or recurrent aspiration

  3. Decline in systolic blood pressure to below 90 systolic or progressive postural hypotension

  4. Increasing emergency visits/hospitalizations, or physician follow-up

  5. Decline in Functional Assessment Staging (FAST) for dementia

  6. Multiple progressive Stage 3-4 pressure ulcers in spite of optimal care.

In the absence of one or more of the above findings, rapid decline or comorbidities may also support eligibility for hospice care.