Renal disease

No dialysis Creatinine clearance < 10cc/min (15cc/min in diabetics) Supporting indicators: Signs of uremia Intractable fluid overload Oliguria <400cc/24 hours

Renal disease2019-04-02T23:52:30+00:00

CVA (Stroke/Coma)

Karnofsky 40% or less Nutritional status decline Dependent for all care Weight loss Dysphasia No consistent or meaningful speech Supporting indicators: Aspiration

CVA (Stroke/Coma)2018-07-23T19:06:30+00:00


Impaired breathing capacity Increased assist in ADLs Decline in speech Progression from normal to pureed diet Progression from independent ambulation to wheelchair


Liver Disease

PTT > 5 sec above control Serum albumin < 2.5 g/dL Ascites despite diuretics Peritonitis Hepatorenal syndrome Encephalopathy Recurrent variceal bleeding Supporting

Liver Disease2018-07-23T19:11:46+00:00

Acute or Chronic Kidney Failure

Not seeking dialysis or transplant Creatine clearance <10cc/min, <15cc/min for diabetics Serum creatine >8.0mg/dl, >6.0mg.dl for diabetics Supporting conditions Uremia Oliguria Hyperkalemia

Acute or Chronic Kidney Failure2018-07-23T19:11:52+00:00


Dyspnea at rest Poorly responsive to bronchodilators Decreased functional capacity Fatigue Recurrent infections Increasing ER visits Weight loss Resting heart rate >


Alzheimer’s Dementia

Stage seven or beyond on the FAST scale Unable to ambulate without assistance Unable to dress without assistance Unable to bathe without

Alzheimer’s Dementia2019-04-01T18:16:20+00:00


Clinical findings of malignancy with widespread, aggressive, or progressive disease Impaired performance status Increasing symptoms, worsening lab values Refuses further curative therapy


Heart Disease

Poor response to treatment NYHA Class IV heart failure Discomfort with physical activity Supporting indicators: History of cardiac arrest Unexplained syncope Cancer

Heart Disease2018-07-23T19:10:51+00:00

General Indicators

Patient/family desires comfort or palliative care Physical decline Increased assistance with ADLs Multiple co-morbidities Weight loss Serum albumin < 2.5 g/dL Frequent

General Indicators2019-03-25T11:29:39+00:00