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

ALS

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

ALS2018-07-23T19:11:40+00:00

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

Pulmonary/COPD

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

Pulmonary/COPD2018-07-23T19:11:58+00:00

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

Cancer

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

Cancer2018-07-23T19:12:09+00:00

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