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Hospice Eligibility Criteria for ALS

Amyotrophic lateral sclerosis (ALS) is a progressive neurological disease that gradually affects muscle control, mobility, speech, swallowing, and breathing. Hospice may be appropriate when ALS has advanced, the patient is experiencing significant functional decline, and life expectancy is six months or less if the disease follows its expected course. 
 
The ALS hospice criteria consider disease progression, respiratory function, nutritional decline, infections, daily care needs, and the patient’s goals for treatment. 

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ALS hospice eligibility

A patient may meet ALS hospice eligibility criteria when the disease is progressing rapidly and leading to significant changes in function, symptoms, or overall health, including: 

 

  • Rapidly progressing disease 
  • Dyspnea at rest 
  • Needs O2 at rest 
  • Poor oral intake of food or fluid 
  • Weight loss 
  • Recurrent infection (such as pneumonia, pyelonephritis or sepsis) or recurrent fever after antibiotics 
  • Decubitus ulcers 
  • Vital capacity < 40% of normal 
  • Desire not to be intubated 
  • Desire not to be hospitalized 
  • Other comorbid disease that may shorten survival 
  • Difficulty with feeding, ambulation, continence, transfer, bathing, or dressing 

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When to call hospice for ALS

Consider calling hospice when ALS symtoms are progressing rapidly and the patient is experiencing increasing difficulty breathing, swallowing, eating, moving, or completing daily activities. Hospice may also be appropriate when weight loss, recurrent infections, or greater dependence on caregivers becomes more pronounced, or when the patient chooses to focus on comfort rather than hospitalization or invasive treatment. 

Contact Samaritan for hospice care

If you or a loved one is living with advanced ALS, Samaritan can help you understand whether hospice care may be appropriate. During an evaluation, the hospice team reviews disease progression, changes in breathing or swallowing, nutritional needs, functional decline, and overall goals of care to determine whether the patient meets ALS hospice eligibility criteria. 
 

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Learn how hospice can help manage symptoms, promote comfort, and support both patients and families

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