Huntington’s Disease

Patient must have both 1 and 2.

  1. Stage VII or beyond according to FAST[1] with all of the following:
    1. Inability to ambulate without assistance
    2. Inability to dress without assistance
    3. Urinary or fecal incontinence (intermittent or constant)
    4. No consistent meaningful/reality based verbal communication


  2. Has had at least (1) of the following conditions within the past (12) months:
    1. Aspiration pneumonia
    2. Pyelonephritis or other upper urinary tract infection
    3. Septicemia
    4. Pressure ulcers, many and/or above stage 3
    5. Toxoplasmosis unresponsive to therapy
    6. Recurrent fever after antibiotics
    7. Inability to maintain sufficient fluid and calorie intake with (1) or more of the following during the last (12) months:
      1. 10% weight loss during the previous (6) months
      2. serum albumin <2.5 gm/dl.
      3. Significant dysphagia with associated aspiration measured objectively (e.g. swallowing test or a history of choking/gagging with feeding).

[1] Refers to Functional Assessment Scale

In the absence of one or more of the above findings, rapid decline or comorbidities may also support eligibility for hospice care. 

Other guides:
CHF/Heart Disease
COPD/Pulmonary Disease
CVA /Stroke/Coma
Liver Disease
Neurological Diseases 
      ALS (Amyotrophic Lateral Sclerosis)
      Muscular Dystrophy
      Myasthenia Gravis
      MS (Multiple Sclerosis)
Renal Failure, Chronic or Acute

Assessment Tools
Palliative Performance Scale (PPS)
New York Heart Association (NYHA) Functional Classes
Functional Assessment Staging (FAST) Scale

Frequent Co-Morbidity documentation requirements
Cachexia or Protein Calorie Malnutrition

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