Patient Eligibility

Montgomery Hospice and Prince George’s Hospice can help patients with any illness, including cancer, dementia, heart disease and others.

A requirement for admission to hospice care includes a Certification of Terminal Illness.  This document, signed by the patient’s own physician in conjunction with the hospice medical director, states that the patient’s life expectancy is six months or less, should the terminal illness run its normal course.

The determination of life expectancy, or prognostication, can be very difficult. A patient may be eligible for hospice care if he or she has one or more of the following:

  • Physical decline; increased dependence with ADLs/IADLs
  • Sudden, unexpected weight loss
  • Decreased oral intake; related to worsening debility and/or dysphasia
  • Multiple comorbid conditions
  • Frequent or recurrent infections; UTI, pneumonia
  • Frequent, recent hospital visits
  • Advanced disease that for which the patient declines aggressive care

The disease-specific criteria on the End-Stage Indicators page provide general guidelines for health professionals to aid in determining a patient’s hospice eligibility.

You can also download the Core Indicators (in PDF format).

More Information on Specific Diseases

A patient with heart disease may be eligible for hospice care if he or she has one or more of these:

  • Trouble breathing at rest, even without exertion
  • Difficulty carrying out daily tasks (because of water-retention, difficulty breathing, or generalized weakness)
  • Taking multiple medications for high blood pressure and water retention but they are not working well
  • Trouble with heart rhythm (has or does not have a pacemaker and/or internal defibrillator)

A patient with lung disease may be eligible for hospice care if he or she has one or more of these:

  • Trouble breathing at rest, even without exertion
  • Difficulty carrying out daily tasks (because of difficulty breathing or generalized weakness)
  • Frequent lung infections

Is taking multiple medications for breathing that don’t seem to work well

A patient with kidney disease may be eligible for hospice care if he or she has one or more of these:

  • Poor kidney function that requires dialysis
  • Inability to receive dialysis or kidney transplant
  • Decreased amount when urinating
  • Swelling/fluid retention
  • Mental changes (confusion, nausea) with constant itching
  • Difficulty carrying out daily tasks because of generalized weakness

A patient with dementia may be eligible for hospice care if he or she has one or more of these:

  • Incontinence of bowel and bladder
  • Speech of less than 6 different words per day
  • Dependence on others for activities of daily living (dressing/bathing/grooming)
  • Inability to sit up or hold head up without help
  • Inability to walk without help
  • Frequent infections
  • Weight loss

A patient with ALS may be eligible for hospice care if he or she has one or more of these:

  • Trouble breathing even at rest, on oxygen
  • Patient/family decline artificial means of respiratory care (ventilator)
  • Difficulty swallowing
  • Difficulty carrying out daily tasks (because of difficulty breathing or generalized weakness)
  • Weight loss
  • Frequent infections and/or wounds
  • Patient/family decline artificial nutrition (tube feed)

A patient with HIV/AIDS may be eligible for hospice care if he or she has one or more of these:

  • Anti-retroviral therapy is no longer effective
  • Very low CD4 load and/or very high viral load
  • Frequent infections and/or wounds
  • Mental changes (confusion, poor judgment, decreased coordination)
  • Difficulty managing activities of daily living (dressing/bathing/grooming)

A patient with cancer may be eligible for hospice care if he or she has one or more of these:

  • Cancer spreading to other organs in the body
  • Uncontrolled symptoms associated with the cancer (like pain or nausea)
  • Chemotherapy and/or radiation-therapy no longer effective or not an option
  • Weight loss
  • Difficulty managing activities of daily living (dressing/bathing/grooming)
  • Frequent infections
  • Patient/family decide to no longer pursue aggressive treatment

A patient with liver disease may be eligible for hospice care if he or she has one or more of these:

  • Cirrhosis, not a candidate for an organ transplant
  • Frequent, difficult to control bleeding
  • Abdominal swelling not improved with medications
  • Infections
  • Mental changes (confusion, lack of judgment, agitation)
  • Difficulty carrying out daily tasks due to generalized weakness

A patient who has had a stroke or is in a coma may be eligible for hospice care if he or she has one or more of these:

  • Coma or “persistent vegetative state” for more than 3 days
  • Inability to eat/drink to sustain life
  • Dependent on others for activities of daily living (dressing/bathing/grooming)

Direct Admissions Referral Line: 301-637-1888 (8:30 am to 4:30 pm, 7 days a week)
Or, call 301-921-4400 any time, any day.