Patients with Pulmonary Disease
(1 and 2 should be present; documentation of 3, 4 and 5 will lend supporting documentation)
- Severe chronic lung disease as documented:
- Disabling dyspnea at rest, poorly responsive or unresponsive to bronchodilators, bed-to-chair existence, fatigue, and cough. FEV1 <30% of predicted after bronchodilator is helpful but not necessary.
- Progression of end-stage pulmonary disease as evidenced by prior increasing ER visits or prior hospitalizations for pulmonary infections and respiratory failure.
- FEV1 >40 ml/year is helpful but not necessary
- Hypoxemia at rest on room air, as evidenced by p02 <55 mmHg or oxygen saturation <88%; or hypercapnia, as evidenced by pCOO2 >50 mmHg
- Cor pulmonale and right heart failure secondary to pulmonary disease (not secondary to left heart disease or valvulopathy)
- Unintentional progressive weight loss of greater than 10% of body weight loss of greater than 10% of body weight over the preceding six months
- Resting tachycardia >100/min
We develop and individualized and specific Plan of Care – as the cancer advances patients experience functional and physiological decline. We develop a POC that addresses pain, anxiety, hydration, shortness of air, psychological factors, hydration, nutrition, skin care, nausea, weakness and incontinence – all common issues needed to be address with a Plan of Care for a COPD patient.