I’m Considering Hospice

If you are considering the kind of care only Hospice can provide perhaps this short survey will be helpful.

Have you or your loved one…

  1. Been hospitalized or to the emergency room several times in the past six months?
  2. Been making more frequent phone calls to your physician?
  3. Started taking medication to lessen physical pain?
  4. Started spending most of the day in a chair or bed?
  5. Fallen several times over the past six months?
  6. Started needing help from others with two or more of the following:
    • Bathing
    • Dressing
    • Getting out of bed
    • Walking
    • Eating
  7. Started feeling weaker or more tired?
  8. Experienced weight loss so that clothes are noticeably looser?
  9. Noticed a shortness of breath, even while resting?
  10. Been told by a doctor that life expectancy is limited?

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VistaCare