HOSPICE STROKE
AND/OR COMA
·
A Palliative Performance Scale (PPS) of
> 40.
a. Degree of
ambulation
• Mainly in bed
b. Activity/extent of disease
• Unable to do work; extensive disease
c. Ability to do self-care
• Mainly Assistance
d. Food/fluid intake
• Normal to reduced
e. State of consciousness
• Either fully conscious or drowsy/confused
Inability to maintain hydration and
caloric intake with one of the following:
a. Weight loss
=10% during previous 6 months
b. Weight loss
=7.5% in previous 3 months
c. Serum albumin < 2.5 gm/dl
d. Current
history of pulmonary aspiration without effective response to speech language
pathology interventions to improve dysphagia and decrease aspiration events.
Calorie counts
documenting inadequate caloric/fluid intake.
If a beneficiary does not meet both medical criteria #1 and #2 the documentation
should describe a relevant comorbidity and/or rapid decline.
The medical
criteria listed below would support a terminal prognosis for individuals with a
diagnosis of coma (any etiology):
Comatose
patients with any 3 of the following on day three of coma:
a) abnormal brain stem response
b) absent
verbal response
c) absent
withdrawal response to pain
d) serum
creatinine >1.5 mg/dl
If you have any
questions please call
Grace Hospice
of