Understanding the hospice criteria for stroke is essential when healthcare professionals are considering a hospice care plan. The hospice eligibility for stroke or cerebral vascular accident (CVA) is based on the patient’s prognosis and includes specific requirements to qualify for hospice services.
To meet stroke hospice criteria, the patient must have had an acute CVA within the past 14 days or a subacute stroke within the past six months. The patient must also meet certain criteria for their prognosis and medical condition.
The patient should have a prognosis of fewer than six months if the disease runs its normal course, as determined by the hospice physician in collaboration with the attending physician.
Criteria for Stroke
Patients will be considered to be in the terminal stage of stroke (CVA) or coma if they meet the following criteria.
Criteria 1 and 2 are important indicators of functional and nutritional status and will support a terminal prognosis for patients with a stroke diagnosis. Number 3 will lend support.
- Poor functional status with a Palliative Performance Scale (PPS) of 40 or less. All criteria in number 1 should be met:
- Mainly bed-bound
- Unable to work
- Requires maximal assistance to perform self-care
- Food and fluid intake is normal or reduced
- Either fully conscious or drowsy and confused
- Inability to maintain hydration and caloric intake with ONE of the following:
- Weight loss >10% during the previous six months
- Weight loss > 7.5% in the last three months
- Serum albumin
- 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.
- Dysphagia is severe enough to prevent the patient from receiving food/fluid necessary to sustain life in a patient who does not receive artificial nutrition/hydration.
- Documentation of medical complications within the previous 12 months, in the context of progressive clinical decline, will help support eligibility for hospice care.
- Recurrent or intractable infections such as pneumonia or other URI
- Urinary tract infection
- Refractory stage 3-4 decubitus ulcers
- Fever recurrent after antibiotics
These criteria will help determine if the patient meets hospice criteria for CVA.
Criteria for Coma from a Stroke
The medical criteria listed below would support a terminal prognosis for individuals with a diagnosis of coma (any etiology). Comatose patients with any three of the following on day three of coma are considered terminal:
- Abnormal brain stem response
- Absent verbal response
- Absent withdrawal response to pain
- Serum creatinine >1.5 mg/dl
If a patient meets the medical criteria above, they are, by definition, eligible to receive hospice services. Some patients may not meet the criteria but may still be eligible for hospice care due to comorbidities or rapid functional decline. Contact a local Compassus program for information about what happens next when a loved one is diagnosed with a coma from a stroke.
Why Is It Important to Understand Hospice Criteria for a Stroke?
Understanding the criteria for a stroke and how it fits into hospice care is integral to receiving the most appropriate and individualized care. Not only is understanding these criteria valuable for determining the optimal type of treatment, but it can also be beneficial in learning more about what to expect and preparing emotionally for the impacts of the condition on oneself or a loved one. Taking time to learn about key elements of stroke diagnosis in the context of hospice can provide a sense of control over an uncertain situation and peace of mind knowing that you are equipped with the knowledge needed to make difficult decisions.
Get Help from Compassus
Understanding hospice criteria for stroke is essential when considering a hospice care plan. The patient must meet specific criteria to qualify for hospice, and knowing these criteria can help families make the best decisions for their loved one’s end-of-life care.
The team at Compassus understands that making decisions about hospice care can be difficult. Our care teams are here to provide support and answer any questions you may have. We’ll help you every step of the way, from determining hospice eligibility to providing compassionate care to your loved one.
Contact us today at 833.380.9583 for more information about hospice criteria for stroke or CVA and how Compassus can provide the quality end-of-life care needed for your family’s peace of mind.