For Professionals

Collaborating for Compassionate Care

  • Hospitals

    Hand in Hand Hospice collaborates closely with hospitals and emergency departments to elevate patient outcomes. Our mission is to deliver excellent patient care to assist our hospital partners to decrease re-admissions, avoidable days, mortality rates, and emergency room visits.

  • Assisted Living & Long Term Care

    Our team enhances the care provided by your facility. We excel in symptom and pain management, with on-call services available 24/7 for uncontrolled symptoms and after-hour care, ensuring the highest quality of support for your residents. We collaborate to combine our knowledge and experience with your team’s to create personalized care plans to meet the needs of your residents.

  • Physicians & Clinics

    At Hand in Hand Hospice, we partner with physicians to enhance patient care by providing specialized pain and symptom management, along with monitoring and support. Our collaboration increases resources for your practice and patient and family quality of life.

Determining Eligibility

At Hand in Hand Hospice, we recognize that deciding the right time to make a hospice referral can be challenging. However, many families we support often share that they wish they had discovered hospice services sooner. Your early identification is key to your patients receiving the most from their benefit.

To help you connect patients and their families with the care they need, we have compiled a list of common diagnoses and clinical indicators that may suggest eligibility for hospice services. If two or more symptoms within a particular category are present, call us to initiate a free hospice evaluation.

    • Persistent symptoms of recurrent heart failure at rest

    • Optimally treated with diuretics and vasodilators

    • Ejection fraction of 20% or less

    • Abnormal heart rhythms resistant to therapy

    • Unexplained syncope

    • Cardiac arrest or heart attack

    • Poorly controlled angina

    • Increased fatigue/weakness

    • Unintentional weight loss

    • Increased oxygen use

    • Receiving supplemental oxygen

    • Shortness of breath at rest

    • Resting tachycardia > 100 bpm

    • Presence of cor pulmonale or right heart failure

    • Hypoxemia at rest

    • pO2 < to 55 mmHg, PCO2 > or = to 50 mmHg

    • Oxygen saturation < or = to 88%

    • Patient is not a candidate for/not electing to pursue further curative treatment

    • Patient has a suspicious tumor and is unable to get a definitive diagnosis

    • Increasing pain and/or symptoms

    • Metastases and/or stage 3 or 4

    • Curative treatment is not effective and/or is having a negative impact on patient's quality of life

    • Dialysis burdens outweigh the benefits

    • Creatinine clearance, < 10 cc/min (< 15 for diabetes)

    • Serum creatinine > 8.0 mg/dl (> 6.0 mg/dl for diabetes)

    • Patient is not seeking dialysis or a renal transplant

    • Ability to speak is limited, or speech is nonsensical; ability to speak is limited to six words or less per day

    • Unable to bathe without assistance

    • Non-ambulatory or ambulatory with significant assistance

    • Incontinence

    • Dependent in ADLs

    • Stage 7 or higher on FAST (see page 14)

    • Decrease in cognitive status

    • Unintentional progressive weight loss > 10% of body weight during the preceding six months

    • Serum albumin < 2.5 mg/dl

    • Prothrombin time prolonged more than five seconds over control or International Normalized Ration > 1.5

    • Serum albumin < 2.5 gm/dl

    • At least one of the following:

    • Ascites, refractory to treatment, or the patient is non-compliant

    • History of spontaneous bacterial peritonitis

    • Hepatorenal syndrome: elevated creatinine and BUN with oliguria < 400 ml/day and urine sodium concentration < 10 mEq/l

    • Hepatic encephalopathy

    • History of recurrent variceal bleeding

    • Physician confirmation of non-recovery/diagnosis of CVA

    • Persistent vegetative state beyond three days

    • Insufficient intake to sustain life with >10% weight loss in 6 months or >7.5% weight loss in 3 months or albumin < 2.5 gm/dl

    • History of pulmonary apriation

    • No meaningful verbal communication

    • CD4 + count < 25 cells/mcL or persistent viral load > 100,000 copies/ml plus one of the following:

    • CNS lymphoma

    • Loss of at least 33% body mass

    • Cryptosporidium infection

    • Systematic lymphoma with advanced HIV disease and partial response to chemotherapy

    • Visceral Kaposi's sarcoma

    • Renal failure in the absence of dialysis

    • Progressive multifocal leukoencephalopathy

    • Toxoplasmosis (unresponsive to therapy)

    • Untreated, unresponsive to treatment, or refused treatment for Mycobacterium avium complex

Start the Discussion

Discussing advanced care planning and/or hospice services can be a sensitive conversation. By fostering an open dialogue about patients' personal goals and values, you play a key role in navigating patients and families through the complexities of their healthcare decisions. To better understand if hospice care might align with your patients' wishes, consider asking the following questions:

  • What are the patient’s current health goals?

  • Will continued treatment significantly prolong their life?

  • Is treatment enhancing or diminishing their quality of life?

  • Is the decision to continue treatment driven by their own wishes or the expectations of loved ones?

  • What matters most to them at this stage?

We understand that you may still want additional support during this process. Our team is skilled in facilitating these important conversations and is ready to assist with advanced care planning. Contact our office to schedule a family meeting with one of our compassionate community representatives.

Refer a Patient

To refer a patient to our services, please complete the form below. A member of our team will respond to your request to gather additional details and begin the process of coordinating care with the patient and their loved ones.