General (non-specific) Terminal Illness
- Terminal condition cannot be attributed to a single specific illness. And
- Rapid decline over past 3-6 months Evidenced by: Progression of disease evidenced by sx, signs and test results Decline in PPS to less than or equal to 50%
Adult Failure to Thrive
Patients meet ALL of the following:
- Palliative performance Scale less than or equal to 40%
- BMI less than 22
- PT refusing enteral or parenteral nutrition support or has not responded to such nutritional support, despite adequate caloric intake
Patient meets ALL of the following:
- Clinical findings of malignancy with widespread, aggressive or progressive disease as evidenced by increasing sx, worsening lab values and/or evidence of metastatic disease.
- Palliative performance Scale (PPS) less than or equal to 70%
- Refuses further life-prolonging therapy OR continues to decline in spite of definitive therapy.
The patient has both 1 and 2:
- Stage 7C or beyond according the the FAST Scale AND
- One or more of the following conditions in the 12 months: Aspiration pneumonia, Pyelonephritis, Septicemia, Multiple pressure ulcers (stage 3-4), Recurrent Fever, Other significant condition that suggests a limited prognosis, and Inability to maintain sufficient fluid and calorie intake in the past 6 months (10% weight loss or albumin less than 2.5 gm/dl)