|
Cancer
|
The
cancer has spread to multiple sites in the body
|
| There
has been weight loss |
| The
patient and family choose palliative, or comfort care |
|
Heart Disease
|
Has discomfort with physical
activity |
| Has heart
disease symptoms despite maximum medical management |
| Has irregular
heart beat which won't respond to medicine |
| Has had
cardiac arrest |
| Has had a stroke as
a result of a blood clot being released from the heart |
|
Dementia
and/or General Decline
|
Unable
to walk without assistance |
| Patient
is unable to control urine and feces |
| Speech
is limited to a few words |
| Unable
to dress without assistance |
| Unable
to sit up or hold head up |
| Complications
occur such as bed sores, pneumonia, urinary tract infections |
| Difficulty
swallowing or eating |
| Weight
loss |
|
Pulmonary Disease
|
Short of breath at rest |
| Bronchodilators
do not work well any more |
| Recurrent
lung infections |
|
Right
sided heart failure/cor pulmonale
|
|
Weight loss
|
| Fast heart
beat, even when resting |
| Low oxygen levels
in blood and high carbon dioxide levels in blood
|
ALS
(Lou Gerig's Disease)
|
Unable to
walk and needs assistance with day to day activities |
|
Barely
understandable speech
|
|
Difficulty
swallowing
|
|
Weight
loss
|
| Significant
shortness of breath |
|
Other
ongoing illnesses such as pneumonia, urinary tract infections
|
|
HIV/AIDS
|
Wasting syndrome (huge
weight loss)
|
| Central nervous system
lymphoma |
| Kaposi's sarcoma |
|
AIDS dementia (severe
confusion)
|
|
Patient decides
not to take antiretrovirals or AIDS medicines
|
|
Patient has other illnesses
together with AIDS and/or severe infection
|
|
LIVER
DISEASE
|
Patient
is not a liver transplant candidate |
| Patient
has a large amount of fluid in abdomen, despite taking
medicine for this |
|
Patient
has infection in abdomen
|
|
Hepatorenal
syndrome - progressive renal failure
|
|
Patient
has confusion which is also associated with sleepiness
and coma
|
|
Recurrent
variceal bleeding (bleeding from the veins in the esophagus
which have become distended)
|
|
STROKE & COMA
|
Patient not always alert
and aware of surroundings |
|
Patient is in a coma
or vegetative state
|
|
Patient has difficulty
swallowing
|
| Patient
is paralyzed |
|
There is dementia after
a stroke
|
|
Despite artificial nutrition
there is continued weight loss
|
| The patient has other
ongoing illnesses (pneumonia, etc.) |
|
RENAL
DISEASE
|
No dialysis,
no renal transplant
|
|
Uremia
- symptoms include confusion, nausea, pruritus and restlessness
|
|
Increased
swelling of fluid in body despite taking medicine for
this
|
|
Very
low levels of urine production - less than 400cc each
day
|
| High
potassium levels in blood
|
