When to Refer

Knowing when to refer a patient for a hospice evaluation can be difficult. Instead of asking yourself if your patient has a prognosis of six months or less, consider asking yourself the “surprise” question:

“Would I be surprised if I saw my patient’s name in the obituary column of the local newspaper in the next year?”


While coverage for hospice services is available through Medicare, Medicaid and most insurances, it is significantly underused by patients across the country, including in Minnesota. Because many patients enter hospice care late in the course of their life-limiting illness they and their families often report they wished they had utilized hospice sooner.


Some signs that may indicate eligibility for hospice care:

  • Increased or uncontrolled pain
  • Decline in ability to perform activities of daily living (ADLs)
  • Frequent infections
  • Frequent hospitalizations or ER visits
  • Increased weakness and/or fatigue
  • Increased skin problems
  • Withdrawal, confusion, bedbound
  • Progressive decline, in spite of curative medical therapies
  • Patient verbalizes “I am ready to die”


Patients may have one or more of the following diagnoses to qualify for hospice:

  • Alzheimer’s disease and advanced dementia
  • Heart diseases
  • Liver disease
  • Renal disease
  • Cancer
  • Pulmonary diseases
  • COPD
  • ALS
  • Parkinson’s

Hospice of Douglas County
809 Elm Street, Suite 1200
Alexandria, MN 56308

Phone: 320-763-6018
Fax: 320-763-4127

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