Terminal Diseases
Medicare guidelines specify fifteen diseases that may qualify as terminal. In order to qualify for Medicare hospice coverage, the hospice medical director must certify that the prospective hospice patient has one or more of these enumerated diseases or else qualifies under the non-specific category designated as "failure to thrive."
The most common and debilitating of these terminal diseases are advanced metastatic cancer, which accounts for more than half of all hospice patients, irreparable organ failure, such as decompensated cirrhosis of the liver and uremia not amenable to dialysis, Stage IV congestive heart failure, irreversible respiratory failure, sepsis, and anoxic encephalopathy.
Modern medicine and technology can delay the onset of death, but unfortunately such technological advances increasingly bring both opportunities and challenges. For patients with a life-threatening chronic or terminal condition, some medical treatments offer little benefit and may only increase the burden of living. Such treatments may only extend the symptoms of the underlying disease.
Each of the terminal diseases exhibits typical symptoms, which can be alleviated in palliative care. The most common of these are dyspnea (labored and painful breathing), respiratory secretions, dysphagia (difficulty in swallowing), cough, painful hiccups, nausea, cachexia (ka-keks-e-a, dehydration and emaciation), constipation, diarrhea, bowel obstruction, pruritis (skin inflammation), neuropathy (nerve pain), fatigue, anxiety, severe depression, delirium, and combinations of these.
These sixteen diseases are the following:
- Cancer
- Stroke
- Acute Cerebrovascular Accident (CVA)
- Dementia
- Alzheimer's Dementia
- Cardiac Disease
- Heart Disease
- Congestive Heart Failure (CHF)
- Pulmonary Disease
- Chronic Obstructive Pulmonary Disease (COPD)
- Emphysema
- Liver Disease
- Renal Disease
- AIDS
- Amyotrophic Lateral Schlerosis (ALS)
- Failure to Thrive
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