The following signs and symptoms may indicate an appropriateness for hospice services. Clinical guidelines for referral to hospice are listed below as well.

Signs & Symptoms:

Uncontrolled or Increased Pain

Increased Dyspnea (difficulty in breathing)

Progressive Edema (accumulation of fluid)

Uncontrolled Nausea/Vomiting

Oxygen Dependence

Progressive Weight Loss

Progressive Renal Insufficiency

Frequent Infections

Frequent Hospitalizations

Profound Weakness and Fatigue

Progressive Decline

Clinical Guidelines for Referral:

An advanced illness with a prognosis of 6 months or less and/or the family has elected palliative (comfort) care

AND/OR

A declining functional status, as determined by either:
     - Karnofsky Performance Status of 50% or less
     - Dependence in 3 of 6 activities of daily living (ADL's)

AND/OR

An unintentional weight loss of more than 10% of body weight over the last four to six months.

AND/OR

An observable and documented deterioration in overall clinical condition in the past four to six months, as manifested by at least one of the following:
     - More than 3 hospitalizations or ER visits
     - Decreased tolerance to physical activity
     - Decreased cognitive ability
     - Other comorbid conditions

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