Referral criteria
- Admission from long-term care facility
- Declining ability to complete activities of daily living
- Difficult-to-control physical or emotional symptoms
- DNR order conflicts
- Doubts regarding the use of non-oral feeding/hydration in cognitively impaired, patients over 65, or dying patients
- Family request for non-beneficial treatments or therapies
- Limited social support (homeless, no family or friends, overwhelmed caregivers)
- New diagnosis of life-limiting illness for symptom control, patient/family support
- Palliative Performance Scale of 60 or less
- Patient or family psychological or spiritual/existential distress
- Patient, family, or physician request for information regarding hospice appropriateness
- Patient, family, or physician uncertainty regarding prognosis and/or non-beneficial treatment options
- Progressive metastatic cancer
- Two or more hospitalizations for illness within three months
- Weight loss

See reference for more information.

Adapted from Center to Advance Palliative Care (CAPC). Palliative care referral criteria: COVID-19 context. Internet. Available at https://www.capc.org/covid-19/palliative-care-referral-criteria-covid-19-context/. Accessed on October 6, 2020.