Liver Disease - For Physicians
To qualify for hospice, patients must have:
- Prothrombin time prolonged more than 5 seconds over control, or International Normalized Ratio > 1.5
- Serum albumin < 2.5 gm/dl
And exhibit at least one of the following:
- Ascites, refractory to treatment or patient non-compliant
- Spontaneous bacterial peritonitis
- Hepatorenal syndrome
- Hepatic encephalopathy, refractory to treatment or patient non-compliance
- Recurrent variceal bleeding, despite intensive therapy
The following factors support a hospital referral:
- Progressive malnutrition
- Muscle wasting with reduced strength and endurance
- Continued active alcoholism (>80 gm ethanol/day)
- Hepatocellular carcinoma
- Hepatitis B positivity
- Hepatitis C refractory to interferon treatment
Patients awaiting liver transplant who otherwise fit the above criteria may be certified for the Medicare hospice benefit, but if a donor organ is procured, the patient must be discharged from hospice.
Liver Disease - For Families
When is is time for end-stage Liver 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?
- Have you (or your loved one) experienced sudden or progressive loss of functional independence?
- 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?
- Are you (or your loved one) experiencing issues such as abdominal distention or bowel dysfunction?
- Are you (or your loved one) experiencing altered mood or behavior?
- 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.