Hospice Criteria for Parkinson’s Disease

Hospice Criteria for Parkinson's DiseaseParkinson’s disease is a progressive nervous system disorder that affects movement. Certain nerve cells called neurons in the brain gradually break down or die.  Many of the symptoms are due to a loss of neurons that produce a chemical in the brain called dopamine.  When dopamine levels decrease, it causes abnormal brain activity, leading to impaired movement and other symptoms such as thinking difficulties, depression/emotional changes, swallowing problems, chewing and eating problems, sleeping issues, bladder control, constipation to name a few.   Symptoms start gradually, perhaps just a tremor to just one hand, but the disorder progresses causing stiffness or slowing of movement. Sadly, there is no cure for Parkinson’s disease.

Parkinson’s Disease:  Criteria need to qualify for hospice services

The patient must meet the following criteria:

Rapid disease progression and either a or b below:

  • Progression from independent ambulation to wheelchair or bed-bound status
  • Progression from normal to barely intelligible or unintelligible speech
  • Progression from normal to pureed diet
  • Progression from independence in most or all Activities of Daily Living (ADL) to needing major

assistance by caretaker in all ADL

 

AND

  1. Severe nutritional impairment demonstrated by all of the following in the preceding 12 months:
  • Oral intake of nutrients and fluids insufficient to sustain life
  • Continuing weight loss
  • Dehydration or hypovolemia
  • Absence of artificial feeding

OR

  1. Life-threatening complications demonstrated by one or more of the following in the preceding

12 months:

  • Recurrent aspiration pneumonia (with or without tube feedings)
  • Upper urinary tract infections, e.g., Pyelonephritis
  • Sepsis
  • Recurrent fever after antibiotic therapy
  • Stage 3 or Stage 4 pressure ulcer(s)

 

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