The National Hospice and Palliative Care Organization, of which Essence of Life Hospice is a member, states:

Considered to be the model for quality, compassionate care at the end of life, hospice care involves a team-oriented approach of expert medical care, pain management, and emotional and spiritual support expressly tailored to the patient’s wishes. Emotional and spiritual support also is extended to the family and loved ones. Generally, this care is provided in the patient’s home or in a home-like setting operated by a hospice program. Medicare, private health insurance, and Medicaid in most states cover hospice care for patients who meet certain criteria.

If you are wondering whether you or a loved one should be referred to hospice, use the guides below or contact us online or by phone at 319-622-3195 or toll free at 1-877-622-3195. We look forward to talking with you.

Hospice Referral Guide

If you or your patient/family member has experienced some of the following symptoms during the last 6 months, they may qualify for hospice care. Call our hospice staff anytime for a free assessment at 319-622-3195 or toll free at 1-877-622-3195.

  • Weight Loss
  • Decreased/minimal appetite
  • Significant change in assistance needed with activities of daily living
  • Increased need for pain medication
  • Start or increase in oxygen usage
  • Increased confusion
  • Increase in treatments or therapies
  • More restless, withdrawn, isolated
  • Skin breakdown
  • Changes in ambulatory ability
  • Increased hospitalizations

Disease Specific Symptoms

Cardiac Disease (Heart Disease)

  • Increase assistance with ADL’s
  • CHF symptoms while on maximum medical treatment
  • Continued symptomatic CHF while on optimal diuretics and vasodilators
  • Dyspnea or chest pain at rest
  • Ejection fraction of 20% or less

Pulmonary Disease (Lung)

  • Frequent ER visits/hospitalizations
  • Increased oxygen dependency O2 sat <88% while on O2
  • Dyspnea at rest/resting tachycardia Hypercapnea (PCO2>50)
  • 10% weight loss over the past 6 months
  • FEVI <30% after bronchodilator treatment

Cerebrovascular Disease (Stroke/Coma)

  • Bed or chair bound
  • Dependent for ADL’s
  • Poor nutrition, insufficient fluid or caloric intake to sustain life
  • 10% weight loss over the past 6 months

Renal Disease (Kidney)

  • Anorexia
  • Abnormal liver enzymes
  • Ascites/edema
  • Creatinine clearance <10cc/min (<15cc/min for diabetics)
  • Elevated prothrombin time
  • Discontinuing/refusing dialysis


  • Dependent for ADL’s
  • Refusal to eat, poor nutrition, insufficient
  • Fluid or caloric intake to sustain life/refuse artificial nutrition
  • Difficulty swallowing
  • 10% weight loss over the past 6 months
  • Minimal vocabulary
  • Incontinence
  • Bed/chair bound or unable to ambulate without assistance
  • Co-morbidities (pneumonia, decubitus ulcer)


  • Evidence of metastasis or end stage disease
  • Curative aggressive treatment has stopped
  • Anorexia with significant weight loss
  • Requiring pain/symptom management with frequent interventions