Hospice Eligibility

When is it time to choose hospice?

When your loved one receives a diagnosis, it can be difficult to know the right time to bring in hospice. While a hospice referral must be made by a physician, you do not need a referral to meet with a hospice liaison. If you feel that your loved one may benefit from hospice services and would like to learn more, please contact Mary Washington Hospice at 540.741.3580 or Hospice@mwhc.com.

To be eligible for hospice, your loved one may have some or all the following:

Liver Disease

• Abnormal lab results
• Malnutrition
• Fluid buildup in the abdomen
• Internal bleeding
• Loss of brain function due to liver damage

Renal Disease

• The patient is not seeking dialysis or has decided to discontinue dialysis
• The patient is not seeking a kidney transplant
• Abnormal lab results
• Fluid overload that does not respond to treatment
• Drastically reduced amount of urine produced
• Liver failure

ALS (amyotrophic lateral sclerosis, also known as Lou Gherig’s disease)

• Extreme difficulty breathing and has declined mechanical ventilation
• Difficulty speaking and eating
• Patient is confined to bed
• Unable to eat or drink an adequate amount
• Continuing weight loss, dehydration, and has declined feeding tube
• Muscle wasting with reduced strength
• Active alcoholism

Heart Disease

• Have already been treated for heart failure
• Is not a candidate (or has declined) a surgical procedure
• A life expectancy of six months or less
• History of heart attack or resuscitation (CPR)
• History of unexplained syncope (sudden drop in heart rate and blood pressure)
• Stroke or TIA (transient ischemic attack) caused by heart disease
• Significant congestive heart failure with an ejection fraction of less than 20%

Alzheimer’s disease

• A life expectancy of six months or less
• Recurrent infections that are difficult to resolve, such as pneumonia, sepsis, or urinary tract infection (UTI)
• Weight loss that is not due to a reversible cause
• Difficulty breathing or increased breathing rate
• Significant pain that is difficult to control
• Nausea, vomiting, or diarrhea that does not respond to treatment
• Decreased appetite or difficulty swallowing
• Significant increase in assistance needed for activities of daily living (feeding, walking, bathing, dressing, etc.)
• Unable to walk, dress, bathe, or use the restroom without assistance
• The patient has had one of the following in the past year: aspiration pneumonia, kidney infection or other urinary tract infection, septicemia, decubitus ulcers, recurrent fever, or significant weight loss