Who Is Eligible?

For a patient to be eligible for Alpha Omega Hospice services, the attending physician and the Alpha Omega team physician must agree that the patient is terminally ill and has an estimated prognosis of six months or less, if the illness runs its normal course. Patients must also agree that they wish to receive palliative rather than curative care. The Alpha Omega team can evaluate patients and determine if services are appropriate at the time of the referral. The hospice team is always available to meet and explain the benefits of the hospice program. We serve the Fort Worth areas and surrounding communities.

ALS
  • Dyspnea at rest
  • Vital capacity less than 30%
  • Declines artificial ventilation
  • Critical nutritional impairment
  • Rapid disease progression or complication in the preceding 12 months
CANCER
  • Clinical finding of malignancy with widespread, aggressive or metastatic disease
  • Patient no longer seeking curative treatment
  • Palliative Performance Scale equal to or less than 70
DEMENTIA
  • Inability to ambulate or dress without assistance
  • Urinary and fecal incontinence, intermitten or constant
  • No consistent meaningful verbal communication
  • One of the following within last 12 months:
    • Aspiration pneumonia
    • Pyelonephritis or other UTI
    • Septicemia
    • Decubitus ulcers, multiple stage 3-4
    • Inability to maintain sufficient fluid and calorie intake
    • Fever, recurrent after antibiotics
FAILURE TO THRIVE
  • Palliative Performance Scale equal to or less than 40% (mainly in bed, requires assistance with ADL’s)
  • Body Mass Index below 22kg/m2; BMI=703 x (patient’s weight in pounds) + (height in inches)2
  • The patient declines or is not responding to eternal or parenteral nutritional support
HEART DISEASE
  • Poor response to optimal treatment with diuretics, vasodilators, or ace inhibitors
  • Presence of NYHA Class IV CHF or refractory angina
  • Ejection fraction less than 20% (helpful but not required)
  • Not a candidate for, or has declined, resvasularization procedures
LIVER DISEASE
  • PT prolonged more than five seconds over control or INR greater than 1.5
  • Serum albumin less than 2.5gm/dl
  • Must have one of the following:
    • Ascites
    • Hepatic encephalopathy
    • History of recurrent variceal bleeding
    • Spontaneous bacterial peritonitis
    • Hepatorenal Syndrome
Multiple Sclerosis
  • Critical nutritional impairment
  • Rapid disease progression or life threatening complications in the preceding 12 months
  • Critically impaired breathing
NONSPECIFIC TERMINAL ILLNESS
  • Recent rapid clinical decline and disease progression
  • Decline in functional status
  • Weight loss
  • Dependence or assistance for two or more ADL’s
  • Recurrent aspiration
  • Increase in ER visits, hospitalizations or physician contact
  • Progression of cognitive impairment
  • Progressive pressure ulcers in spite of optimal care
  • Dysphagia with recurrent aspiration
PARKINSON’S
  • Critical nutritional impairment
  • Rapid disease progression or complications in the preceding 12 months

PULMONARY DISEASE

  • Decreased functional capacity
  • Evidence of disabling dyspnea at rest, or with minimal exertion
  • Poor response to bronchodilators
  • Progression of disease as evidenced by increasing visits to physician, ER, or hospital for pulmonary infections
  • Hypoxemia on room air less than 88% by oximetry
  • An FEV1 less than 30% (helpful but not required)
RENAL FAILURE
  • Patient is not seeking dialysis
  • Creatinine clearance less than 10cc/min (<15cc/min for diabetics)
  • Serum creatinine greater 8.0mg/dl (>6.0mg/dl for diabetics)
  • Not a candidate for dialysis
STROKE
  • Palliative Performance Scale of 40% or less
  • Poor nutritional status with weight loss over 10% in the past six months or 7.5% in the past three months
  • Serum albumin of less than 2.5
  • Coma with three of the following on third day of coma:
    • Abnormal brain stem response
    • Absent verbal responses
    • Absent withdrawal response to pain
    • Serum creatinine greater than 1.5

Any end stage terminal disease or terminal condition.If you are seeing some of these signs/symptoms, it may be time to contact your physician or Alpha Omega Hospice for an evaluation.

 Fort Worth: 817.383.2240 | Surrounding: 844.617.6440