A patient with amyotrophic lateral sclerosis (ALS) may be a candidate for hospice care if certain criteria are present.


Criteria for hospice admission - all of the following:

(1) There has been a rapid progression in the course of the disease over the past 12 months.

(2) The patient has significant disability.

(3) The patient and family do not wish any further aggressive management, including:

(3a) intubation, tracheostomy or mechanical ventilation

(3b) tube feeding or parenteral nutritional support

(3c) cardiopulmonary resuscitation.

(4) 1 or more severe complications are present (see below).


Severe complications:

(1) vital capacity < 30% of predicted for age and gender

(2) significant dyspnea at rest

(3) supplemental oxygen required at rest

(4) oral intake inadequate, with dehydration and/or hypovolemia

(5) continued weight loss despite tube feedings

(6) recurrent aspiration pneumonia

(7) recurrent fever after antibiotic therapy

(8) pyelonephritis

(9) sepsis

(10) severe decubital ulcer disease (Stage 3 or 4, infected, multiple)


To read more or access our algorithms and calculators, please log in or register.