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Stroke & Coma

Stroke & Coma - For Physicians

The patient has both 1 and 2:

1.  Poor functional status with PPS of 40% or less (unable to care for self)

AND

2.  Poor nutritional status with inability to maintain sufficient fluid and calorie intake with either

  • >10% eight loss over previous six months
  • >7.5% weight loss over previous three months
  • Serum albumin< 2.5 gm/dl
  • Current history of pulmonary aspiration without effective response to speech language pathology interventions to improve dysphagia and decrease aspiration event

Supporting evidence for hospice eligibility:

Coma (any etiology) with three of the followingon the third day of the coma:

  • Abnormal brain stem response
  • Absent verbal responses
  • Absent withdrawal response to pain
  • Serum creatinine > 1.5 gm/dl

In the absence of one or more of the above findings, rapid decline or comorbidities may also support eligibility for hospice care.