Amyotrophic Lateral Sclerosis (ALS)

Call or email the Hospice Team for the most accurate assessment of the patient’s eligibility.

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Eligibility Criteria

Patient meets at least one of the following:

1. Severely impaired breathing capacity with all the following:
   1. Dyspnea at rest
   2. Vital capacity <30%
   3. Requirement for supplemental oxygen at rest
   4. The patient declines artificial ventilation

OR

2. Rapid disease progression as evidenced below:
   1. Progression from independent ambulation to wheelchair or bed-bound status
   2. Progression from normal to barely intelligible or unintelligible speech
   3. Progression from normal to pureed diet
   4. Progression from independence in most or all Activities of Daily Living to needing major assistance by caretaker in all ADLs

OR

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

OR

4. Life-threatening complications demonstrated by one or more of the following in the preceding 12 months:
   5. Recurrent aspiration pneumonia (with or without tube feeding)
   6. Upper urinary tract infection (pyelonephritis)
   7. Sepsis
   8. Recurrent fever after antibiotic therapy
   1. Stage 3 or 4 decubitus ulcer(s)

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