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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

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
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