ADVANCED END STAGE SENESCENCE OR DEBILITY

The patient has:

• Karnofsky Performance Status < 50% and
  At least one of the following conditions within the past 12 months:
• Aspiration pneumonia
• Pyelonephritis or other upper urinary tract infection
• Septicemia
• Decubitus ulcers, multiple, stage 3-4
• Fever, recurrent after antibiotics
• Inability to maintain sufficient fluid and calorie intake with > 10% weight loss during the previous six months or
• A serum albumin of < 2.5 gm/dl
• Significant dysphagia with associated aspiration measured objectively (e.g., swallowing test or a history of choking/gagging with feeding)

A physician may determine that a patient has a life expectancy of six months or less even if the above findings are not present. Co-morbidities also support eligibility for hospice care.