Hospice may be appropriate for patients with a variety of severe lung diseases, including chronic obstructive pulmonary disease, cystic fibrosis, pulmonary fibrosis, chronic asthma, bronchiectasis, chronic bronchitis, emphysema and end-stage tuberculosis.
Eligibility for hospice care requires a diagnosis of 6 months or less of life. Only a doctor can make the determination of life expectancy, though this is typically based on factors such as the patient’s decreased functional capacity and a decision to stop curative treatment or intubation. Once a doctor makes an official hospice referral, the patient can schedule an appointment to determine the specific hospice services they need.
Some specific criteria for recommending a patient to hospice care include:
- Reduced or limited physical response to bronchodilator therapy
- Experiencing dyspnea while at rest or during minimal activity, even while on oxygen therapy
- Frequent or repeated hospitalizations for symptoms of lung disease, including respiratory infections or respiratory failure
- Loss of more than 10% of body weight over six months or less
- Recurrent pneumonia or bronchitis
- Difficulty performing daily activities of living
- Reduced activity to the point of spending most days at home
Clinical lab tests can also help a physician decide when a hospice referral is warranted. Some criteria that could affect the patient’s diagnosis include an oxygen saturation level of less than 88%, a heart rate of more than 100 beats per minute and a forced expiratory volume of less than 30% after using a bronchodilator.
In some cases, patients with end-stage COPD may have additional health issues that affect hospice eligibility and complicate care. Co-occurring conditions such as heart disease, cancer or another serious illness can be addressed alongside end-stage pulmonary disease. The individualized approach of hospice care lets the care team identify the patient’s needs and create a care plan that manages symptoms of multiple illnesses at once.
The main goal of hospice and palliative care is to make the patient as comfortable as possible during the final stages of COPD or advanced lung disease. Patient care takes place wherever the patient resides. This could be at the patient’s home, a relative’s home or an assisted living facility. Receiving care in a familiar setting is a goal of many patients, and your hospice provider can help you achieve this goal. Hospice care may also be available during a temporary inpatient hospital stay.