Hospice is a team of family, friends, health professionals and advisors who work together to create the most comfortable and dignified care for someone with a life-limiting illness.
Bethany Hospice is available for consultation with health and family advisors. The following information provides additional information on indicators and our in-service programs.
For more information, call 412-921-2209 or email us at [email protected].
- Karnofsky 40% or less
- Nutritional status decline
- Dependent for all care
- Weight loss
- Dysphasia
- No consistent or meaningful speech
- Supporting indicators:
- Aspiration pneumonia
- UTI
- Sepsis
- Stage 3-4 decubitus ulcers
- Recurrent fevers
- Impaired breathing capacity
- Increased assist in ADLs
- Decline in speech
- Progression from normal to pureed diet
- Progression from independent ambulation to wheelchair
- One or more of the following:
- Weight loss
- Aspiration pneumonia
- UTI
- Sepsis
- Recurrent fever
- Stage 3-4 decubitus ulcers
- PTT > 5 sec above control
- Serum albumin < 2.5 g/dL
- Ascites despite diuretics
- Peritonitis
- Hepatorenal syndrome
- Encephalopathy
- Recurrent variceal bleeding
- Supporting indicators:
- Malnutrition
- Muscle wasting
- Hepatitis C
- Active alcoholism
- Not seeking dialysis or transplant
- Creatine clearance <10cc/min, <15cc/min for diabetics
- Serum creatine >8.0mg/dl, >6.0mg.dl for diabetics
- Supporting conditions
- Uremia
- Oliguria
- Hyperkalemia
- Albumin <3.5mg/dl
- Dyspnea at rest
- Poorly responsive to bronchodilators
- Decreased functional capacity
- Fatigue
- Recurrent infections
- Increasing ER visits
- Weight loss
- Resting heart rate > 100
- Oxygen dependent
- Stage seven or beyond on the FAST scale
- Unable to ambulate without assistance
- Unable to dress without assistance
- Unable to bathe without assistance
- Urinary and fecal incontinence, intermittent or constant
- Unable to express needs
- One or more of the following:
- Aspiration pneumonia
- Recurrent UTI
- Septicemia
- Stage 3-4 decubitus ulcers
- Recurrent fevers
- Weight loss
- Renal disease
- No dialysis
- Creatinine clearance < 10cc/min (15cc/min in diabetics)
- Supporting indicators:
- Signs of uremia
- Intractable fluid overload
- Oliguria <400cc/24 hours
- Clinical findings of malignancy with widespread, aggressive, or progressive disease
- Impaired performance status
- Increasing symptoms, worsening lab values
- Refuses further curative therapy or no additional therapies are available
- Poor response to treatment
- NYHA Class IV heart failure
- Discomfort with physical activity
- Supporting indicators:
- History of cardiac arrest
- Unexplained syncope
- Cancer
- No aggressive treatments available or being sought
- Patient showing decline
- Patient/family desires comfort or palliative care
- Patient no longer wishes to be hospitalized
- Physical decline
- Increased assistance with ADLs
- Multiple co-morbidities
- Weight loss
- Serum albumin < 2.5 g/dL
- Frequent hospitalizations or trips to the ER
- Increasing pain or weakness
- Life limiting condition
Less common hospice appropriate diagnoses include Multiple Sclerosis, HIV/AIDS, Huntingdon’s Disease, Myasthenia Gravis, and Parkinson’s Disease
In-service List
Bethany Hospice provides speakers and trainers for various events and meetings. Many of our in-service programs qualify for RN and/or SW CEUs. If you are interested in holding a training session or a meeting, please call 412-921-2209 or email us at [email protected].
Available topics include:
- Hospice 101
- Elder Abuse
- HIPAA
- The Hospice Process
- Enjoying the Holidays When a Loved One Has Alzheimer’s
- Determining Hospice-Appropriate Patients
- Safe Management Techniques and Incident Reporting
- Discussing Hospice with Patients and Family Members
- Pain Management
- The Role of Hospice in a Long Term Care Facility
- Stress Management
- Stages of Grief
- Death and Dying
- Laughter Is the Best Medicine
- Advance Directives
- Caring for the Caregiver
- Dealing with Difficult Families
Bethany Hospice is continually developing new in-service topics. If you have a need for a specific in-service program not listed above, please contact us.