Hospice Criteria for CVA/Stroke Patients

Acute phase patients on evaluation 3 das after the acute event should display some:

  • Coma or persistent vegetative state secondary to the CVA
  • Coma or severe obtundation with severe myoclonus in post anoxic injury
  • Dyshagia preventing nutrition adequate to sustain life in a patient who is declining or is not a candidate for artificial nutrition/hydration
  • Clinical estimate of survival is less than six months based on MRI or CT evaluation

Chronic phase patients (should have 1, 2, & 3, plus one complication)

  1. Karnofsky <=40
  2. Serum albumin <2.5 or weight loss of >10%
  3. Incontinence and inability to ambulate without assistance and minimal intelligible speech

Complications

  • Aspiration pneumonia
  • Sepsis
  • Recurrent URI/upper UTIs
  • Recurrent fever after antibiotic treatment
  • Refractory, multi stage 3-4 decubitus ulcers

We develop and individualized and specific Plan of Care – as the Cerebral Vascular Disease/Accidents advance patients experience functional and physiological decline.  We develop a POC that addresses pain, anxiety and aggitation, hydration, psychological factors, nutrition, skin care, recurrent infections, weakness and incontinence – all common concerns with CVA/Stroke.