Tools for Medical Providers
When You Work in End-of-Life Care
Recognizing the Physical Stages of Dying
The world of hospice regulations and financing can sometimes be challenging to navigate. We provide you with some tools and resources on this website that might help.
The current set of tools is focused on estimating life expectancy and on recognizing the physical stages of dyng.
We developed this section of our site in response to a specific request from one of the partner organizations in our service area ... though we are pleased if you find this section useful no matter where you may be located.
Our goal is to continue to add tools to this website over time. In the meantime, if you’d like any information you don’t readily find here, please let us know.
—Tina Castañares MD
Medical Director, Hospice of The Gorge
Is Your Patient Eligible for Hospice?
If you’re wondering whether your patient is hospice eligible, click here for the our prognostic guidelines for hospice eligibility. These guidelines indicate the symptoms and signs associated with the physical stages of dying.
Always remember, however, that comorbidities, overall frailty, frequency of ER and inpatient care, and many psycho-social factors may mean that your patient is eligible even when the physical stages of dying as outlined in these guidelines are not strictly met. Our Medical Directors will be happy to help with that determination.
Determining Hospice Appropriateness
At Hospice of The Gorge, we understand there are many patients who are eligible for hospice prognostically, in that the physical stages of dying are evident. Still, they may not be hospice-appropriate, in that they resist the concept of hospice, wish to pursue more aggressive treatments rather than comfort care, or in some other way can’t be partners in a typical Plan of Care for a community-based hospice outpatient service.
We are always happy to discuss hospice with such patients and their families in our service area, even knowing that they “aren’t ready.”
More Tools to Predict Life Expectancy
A number of on-line tools may prove helpful to you as you as you move through the art and science of prognostication. Click here for the tools related to recognizing the physical stages of dying we recommend. They provide disease-specific information, and allow you to enter or consider data for a particular patient.
We hope you will find these tools helpful to you in estimating the life expectancy of your patients.
Admitting Patients to Hospice
Please call if you want to admit a patient to Hospice of The Gorge. We will be happy to fax you our admitting forms.
We apologize that Medicare requires all notes and orders from Physician Assistants to be co-signed by the PA’s supervising physician or agent. Only MDs, DOs, and NPs may refer and attend hospice patients autonomously.
More Tools Coming Soon!
Our goal is to continue to add tools and resources to this website related to:
- the physical stages of dying
- how to talk with your patients who are dying
- how to best work with hospice organizations and other care providers
You can help by letting us know if these tools are of value to you, and what other types of tools you'd like to see.
Please call or email us at Hospice of The Gorge.
