Heart Disease - For Physicians
To qualify for hospice, patients must have:
- Significant symptoms of recurrent congestive heart failure (CHF) at rest.
- Classification as New York Heart Association (NYHA) Class III or IV.
The following are not required, but support a hospice referral:
At the time of initial certification or recertification for hospice, the patient must have:
- Patient is already optimally treated with diuretics and vasodilators, which may include angiotensin-converting enzymes (ACE) inhibitors or the combination or hydrazine and nitrates. If the side effects, such as hypotension or hyperkalemia, prohibit the use of ACE inhibitors or the combination of hydrazine and nitrates, this must be documented in medical records.
- Patients must have angina pectoris, at rest, resistant to standard nitrate therapy and are either not candidates or decline invasive procedures.
- History of cardiac arrest
- Treatment resistant symptomatic supraventricular or ventricular arrhythmias
- Brain embolism of cardiac origin
- History of unexplained syncope
- Concomitant HIV disease
- Documentation of ejection fraction of 20% or less.
Heart Disease - For Families
When is is time for end-stage Heart Disease hospice care?
Answering these questions may serve as a guide:
- Are your (or your loved one’s) medications no longer effective in managing symptoms?
- Do you (or your loved one) have significant symptoms even while resting?
- Do you (or your loved one) sometimes experience disabling shortness of breath while resting, resulting in decreased ability to do the things you (or he or she) want and need to do?
- Do you (or your loved one) have other health issues such as renal insufficiency or pulmonary (lung) disease?
- Has your physician told you (or your loved one) that a left ventricular assist device (LVAD) or transplant is NOT an option?
- Are you (or your loved one) ready to seek “aggressive comfort care” instead of aggressive treatment?
If you answered “yes” to these questions, now may be an appropriate time to discuss Community Hospice with your physician or one of our clinical professionals. Feel free to call us directly at (251) 943-5015.