Patients who are “hospice-aligned” and whose primary goal of the ED visit is to explore the hospice disposition, be it home with hospice or an inpatient hospice care center bed should be considered for CDU.  

“Hospice-aligned” implies the patient has had an informed discussion with their care providers and have decided on hospice, but were previously too healthy to qualify.  

Exceptions would be an actively dying patient who is likely to pass in the night, one who has intensive nursing requirements to ensure comfort (i.e., those with dyspnea/tachypnea/pain requiring > q4 hour assessment and dosing), a need for attendance to family coping and education and/or a patient for whom it known that an inpatient hospice bed will not be available the next day.  These patients should be admitted to upstairs.  The on-call Palliative Care/Supportive Care physician is available for specific questions.  

Disposition

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