HOPSPICE
AMYOTROPHIC LATERAL SCLEROSIS (ALS)
Criteria:
Patients will be considered to be in the terminal stage of if they meet the
following criteria (must fulfill 1, 2, or 3):
1. The patient
must demonstrate critically impaired breathing capacity
a. Critically
impaired breathing capacity as demonstrated by all the following characteristics
occurring within the 12 months preceding initial hospice certification:
·
Vital capacity
(VC) less than 30% of normal
·
Significant
dyspnea at rest
·
Requiring
supplemental oxygen at rest
·
Patient
declines artificial ventilation
2. Patient
must demonstrate both rapid progression of ALS and critical nutritional
impairment
a. Rapid
progression of ALS as demonstrated by all the following characteristics
occurring within the 12 months preceding initial hospice certification:
·
Progression
from independent ambulation to wheelchair or bed bound status
·
Progression
from normal to barely intelligible or unintelligible speech
·
Progression
from normal to pureed diet
·
Progression
from independence in most or all activities of daily living (ADLs) to needing
major assistance by caretaker in all ADLs.
b. Critical
nutritional impairment as demonstrated by all the following characteristics
occurring within the 12 months preceding initial hospice certification:
·
Oral intake of
nutrients and fluids insufficient to sustain life
·
Continuing
weight loss
·
Dehydration or
hypovolemia
·
Absence of
artificial feeding methods
3. Patient
must demonstrate both rapid progression of ALS and life-threatening
complications
a. Rapid
progression of ALS, see 2.a. above
b.
Life-threatening complications as demonstrated by one of the following
characteristics occurring within the 12 months preceding initial hospice
certification:
·
Recurrent
aspiration pneumonia (with or without tube feedings)
·
Upper urinary
tract infection, e.g., pyelonephritis
·
Sepsis
If you have any questions please call us:
Grace Hospice of