Patient Qualifications for Palliative Care Services

Based on the clinician referral guide from the Center to Advance Palliative Care’s website, Get Palliative Care, patients may qualify for palliative care services in one or more of the following situations.

Presence of a Serious or Chronic Illness, defined by:

  • Weight loss
  • Multiple hospitalizations
  • Do-not-resuscitate order conflicts
  • Limited social support due to factors such as homelessness or chronic mental illness
  • Severe symptom burdens
  • Patient or family psychological or spiritual distress

Intensive Care Unit History, including:

  • Two or more ICU admissions within the same hospitalization
  • Multi-organ failure
  • Family distress that impairs surrogate decision making
  • Prolonged or difficult ventilator withdrawal
  • Consideration of patient transfer to a long-term ventilator facility

Oncology Criteria

Metastatic or locally advanced cancer that is progressing despite systemic treatments with or without weight loss and functional decline.

Note: The American Society of Clinical Oncology recommends palliative care consultation within eight weeks of diagnosis for metastatic cancer. Palliative care may occur alongside active treatment of the patient’s cancer.

Emergency Department Criteria:

  • Multiple recent prior hospitalizations with the same symptoms and problems
  • Long-term-care patient with do not resuscitate or comfort care orders
  • Patient previously enrolled in a home or residential hospice program
  • Consideration of ICU admission or mechanical ventilation in a patient

A more detailed list can be found in the clinician’s section of the Get Palliative Care website.