Definitions:
Conditions/diseases make cognitive, ADL, mood or behavior patterns unstable (fluctuating, precarious, or deteriorating) — For example, the person may have a condition such as ulcerative colitis, rheumatoid arthritis, or multiple sclerosis that causes pain or impairs mobility or sensation, resulting in increased dependence on others and depression.
Experiencing an acute episode or a flare-up of a recurrent or chronic problem — The person is symptomatic for an acute health condition (e.g., new myocardial infarction; adverse drug reaction; influenza) or recurrent acute condition such as aspiration pneumonia or a urinary tract infection. This item also includes those people who are experiencing an exacerbation or flare-up of a chronic condition (e.g., new onset shortness of breath in someone with a history of asthma; increased pedal edema in a person with congestive heart failure). This type of acute episode is usually of sudden onset, has a time-limited course, and requires evaluation by a physician.
End stage disease, 6 or fewer months to live — The person or family has been told that in the best clinical judgment of the physician, the person has end-stage disease with approximately six or fewer months to live.
Process:
Consult with the person and person’s family. Review any clinical records. Use your clinical judgment to determine whether it is appropriate to ask the person about whether they have an “end stage disease”.
Coding:
0. No
1. Yes