Timely identification of hospice-eligible patients increases the likelihood that they and their families will benefit from compassionate, end-of-life care. A patient is eligible for hospice if they have a life expectancy of 6 months or less if their illness runs its normal course.
This page offers resources to help healthcare professionals determine hospice eligibility, including downloadable checklists and referral guidance. Because it can often be difficult to estimate life expectancy, VITAS end-of-life experts are available for consultation.
For a patient to be eligible for hospice, their illness must be terminal (a prognosis of ≤ 6 months) if its normal course and the patient and/or family elects care focused on quality of life.
Factors that can help healthcare professionals determine prognosis include:
經由以下項目之一認定病人的功能狀態逐漸退化：
The patient has alteration in nutritional status, e.g., > 10% loss of body weight over last 4-6 months or 5% in one month.
在過去的4-6個月之間，病人被觀察到並記錄下整體臨床情況的惡化，其表現方式至少包括以下其中一項：
Additional comorbidities that contribute to overall health deterioration may support hospice eligibility, especially when combined with the above factors.
These guidelines—provided as a convenient tool and not as a replacement for a healthcare professional’s judgment—help physicians determine when their patients meet clinical guidelines for hospice eligibility for life-limiting illnesses.
當病人的主治醫師及安寧療護醫師（或是安寧療護的醫療總監或總監的指定代表）皆認為，病人在其疾病的正常發展下，預估生命期最多六個月時即符合安寧療護的資格。 A patient must also decide to forgo curative treatment.
沒有預估是肯定的，接受安寧療護的病人可能存活超過六個月。 In these cases, the patient can continue receiving hospice care if their six-month prognosis is recertified by their hospice physician every 60 days thereafter.
臨床醫事人員將病人轉診至安寧療護是基於特定的根本疾病狀態，此疾病造成六個月或以下的預後。 The hospice physician may collaborate with the referring or attending physician, nurse practitioner or physician assistant to determine which diagnosis is most contributing to the terminality of the patient, but the final decision is the responsibility of the hospice team.
非特定病症或症狀不能列為主要的安寧療護診斷。例如，虛弱及生長遲緩可造成病人呈現末期衰弱，但是已存在的病情，例如心臟衰竭或慢性阻塞性肺病（COPD）才是主要的安寧療護診斷。
The National Alliance for Care at Home provides a full list of ICD-10 codes that cannot be used as primary diagnoses when referring patients to hospice.
Clinicians may encounter a variety of obstacles when discussing hospice eligibility with patients and their families, including:
Clinical guidelines combined with medical judgment determine hospice eligibility, although the decision to choose hospice is one only a patient or their family can make. A healthcare professional may recommend hospice, but a referral is not required. A patient or their family can “self-refer,” meaning they can request an evaluation from a hospice provider at no charge.
