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Patient Eligibility Test

Many people do not realize that hospice isn’t just for someone in the very last weeks of life. Actually, to receive the full benefit of hospice, it is encouraged to enroll as soon as one is eligible. The following is a checklist of common symptoms, but not limited to, that may qualify one for the hospice benefit. If one can answer at least 6 of the following questions YES, please contact us through the website, or call Centennial Hospice at 405-562-1211 to arrange for an evaluation by one of our nurses.

 

Take the test

YES NO Have you lost 10% or more of your body weight in the last 6 months?

YES NO have you been to the hospital more than 2 times in the last 6 months?

YES NO Have you had pneumonia in the last 3 months?

YES NO Have you had a urinary tract infection (UTI) in the last 3 months?

YES NO Have you lost the will to live?

YES NO Do you use oxygen all the time or have increased the frequency of use?

YES NO Are your nebulizer treatments not as effective as they used to be?

YES NO Do you have Stage III or IV wounds (deep into the tissues or bone)?

YES NO Are you unable to do work or hobbies?

YES NO Do you mainly sit or lie?

YES NO Do you require assistance in at least 3 of the following areas? Bathing
Dressing
Eating
Transferring
Walking (confined to a wheelchair or using a walker)
Control of your bladder or bowel

If you answered at least YES to six or more of the above questions, please contact us immediately.