Condition-specific guidance
Hospice eligibility depends on the complete clinical picture and physician certification. These common changes may help families know when to begin a conversation.
Consider a hospice conversation when advanced cognitive decline is accompanied by increasing dependence, reduced communication, difficulty eating or swallowing, weight loss, repeated infections, falls, or other complications.
Comfort assessment, caregiver teaching, skin and safety support, symptom management, personal care, and emotional and spiritual support.
Changes may include worsening shortness of breath, fatigue at rest or with minimal activity, swelling, repeated hospital visits, reduced response to treatment, or growing dependence with daily care.
Breathing and comfort support, medication coordination, equipment, caregiver guidance, and a plan for changes at home.
Changes may include breathlessness at rest, declining activity tolerance, oxygen dependence, repeated respiratory infections or hospitalizations, weight loss, and anxiety related to breathing.
Symptom-focused nursing care, medication and oxygen coordination, energy-conservation teaching, equipment, and caregiver support.
A conversation may be appropriate when disease is progressing despite treatment, treatment is no longer desired or beneficial, symptoms are increasing, nutrition and function are declining, or care goals have shifted toward comfort.
Pain and symptom management, medication and equipment coordination, personal care, counseling, and family support.
Changes may include progressive weakness, impaired communication, repeated aspiration or infections, difficulty swallowing, weight loss, declining mobility, or increased dependence for most daily activities.
Comfort-focused clinical care, positioning and safety teaching, equipment, skin support, personal care, and assistance with difficult decisions.
A conversation may be appropriate when kidney disease is advanced, dialysis is no longer chosen or tolerated, symptoms are difficult to manage, hospitalizations are increasing, or overall function and nutrition are declining.
Management of discomfort and related symptoms, medication review, equipment, caregiver teaching, and coordinated support around the patient’s goals.
Changes may include worsening fluid accumulation, confusion, weakness, bleeding concerns, repeated infections or hospitalizations, poor intake, weight loss, or declining function despite treatment.
Comfort and symptom support, medication coordination, caregiver education, personal care, and emotional and spiritual support.
Changes may include severe mobility loss, frequent falls, increasing dependence, reduced speech, swallowing difficulty, aspiration, weight loss, recurrent infections, or cognitive decline.
Comfort assessment, equipment and safety planning, caregiver teaching, personal care, and support for communication and family decision-making.
