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Pulmonary Disease

Pulmonary Disease - For Physicians

To qualify for hospice, a patient with advanced pulmonary disease must have:

Severe chronic lung disease evidenced by:

  • Disabling dyspnea at rest, poorly or unresponsive to bronchodilators, resulting in decreased functional capacity, e.g., bed to chair existence, fatigue, and cough.
  • Progression of end stage pulmonary disease as evidenced by prior increasing visits to ER or prior hospitalization for pulmonary infections and/or respiratory failure.
  • Hypoxemia at rest on room air, as evidenced by p02 ≤ 55 mmHg or oxygen saturation < or = 88% on supplemental oxygen. Or hypercapnia, as evidenced by p02 ≤ 50 mmHg.
  • Cor pulmonale and right heart failure (RHF) secondary to pulmonary disease (e.g., not secondary to left heart disease or valvulopathy.

The following are not required but support a hospice referral:

  • Unintentional progressive weight loss greater than 10% of body weight in the past six months.
  • Resting tachycardia > 100/min



Pulmonary Disease - For Families

When is is time for end-stage Pulmonary Disease hospice care?

Answering these questions may serve as a guide:

  • Have you (or a loved one) made several trips every few months to the emergency room for respiratory failure or lung infections?
  • Have you (or a loved one) been repeatedly hospitalized every few months and no longer wish to be hospitalized?
  • Do you (or a loved one) no longer wish to be intubated?
  • Are you (or your loved one) ready to seek “aggressive comfort care” instead of aggressive treatment?


If you answered “yes” to these questions, now may be an appropriate time to discuss Longleaf Hospice with your physician or one of our clinical professionals. Feel free to call us directly at 770-939-9179.