85 General End-Stage Disease Guidelines
Changes in clinical variables apply to patients whose decline is not considered reversible
Documented decline in functional status (both should be met)
- Assistance needed with at least 2 ADLs (toilet, feed, dress, groom, walk, bathe)
- Decline in PPS to less than 70%
Decline in nutritional status
- Unintentional progressive weight loss (10% over 6 months)
- Serum albumin < 2.5 gm/dl
- Dysphagia leading to recurrent aspiration and/or inadequate intake
Increased ED visits, physician visits, or hospitalizations related to primary hospice diagnosis
Multiple co-morbidities
Goal for palliative care
- Adult “failure to thrive”
- PPS < 50%
- BMI < 22
- Declining enteral or parenteral nutrition support or has not responded to such nutritional support, despite adequate caloric intake
