What Are the Prognostic Tools Used in Hospice Care Planning?

When planning for hospice care, accurate information is needed to provide the most compassionate and effective end-of-life care. Understanding a patient’s likely life expectancy helps families make informed decisions and ensures appropriate care resources are allocated. Three of the main prognostic tools that can guide hospice professionals in creating personalized care plans include:

• Palliative Performance Scale (PPS) – Assesses functional status and activity levels
• Palliative Prognostic Index (PPI) – Combines clinical observations for cancer patients
• Palliative Prognostic Score (PaP) – Uses comprehensive clinical data and physician assessment

At Shiloh Hospice, these tools, among others, help our compassionate team deliver individualized care that honors each patient’s unique needs and circumstances.

What Are Prognostic Tools?

Prognostic tools are validated assessment instruments that help healthcare professionals predict the short-term survival likelihood of hospice patients. These evidence-based tools provide structure to clinical decision-making and help families understand what to expect during their loved one’s end-of-life journey.

Rather than relying solely on clinical intuition, these standardized assessments offer:

• Objective measurements of patient condition
• More accurate timeline expectations
• Consistent communication among care team members
• Better resource planning for families

Key Prognostic Tools in Hospice Care

Palliative Performance Scale (PPS)

The PPS evaluates five domains of patient function on a scale from 0-100%. It measures ambulation, activity levels, self-care ability, food intake and level of consciousness.

This tool helps medical professionals predict possible life expectancy timeframes:

• Scores above 70%: Several months’ survival likely
• Scores 50-60%: Weeks to months expected
• Scores below 40%: Days to weeks anticipated

The PPS works particularly well for cancer patients and can provide reliable prognostic information across different care settings.

Palliative Prognostic Index (PPI)

The PPI combines the PPS with four additional clinical observations. It scores oral intake, edema, breathing difficulties at rest and any presence of delirium.

PPI scoring includes:

• Score less than 4: Survival likely exceeds 6 weeks
• Score 3-5: Survival shorter than 6 weeks expected
• Score 6 or higher: Survival less than 3 weeks likely

This tool frequently demonstrates high accuracy for short-term prognosis in advanced cancer patients.

Palliative Prognostic Score (PaP)

The PaP incorporates the Karnofsky Performance Scale along with five clinical variables. It includes physician predictions, symptom severity, blood test results and patient appetite.

The comprehensive assessment provides:

• Numerical scores from 0 to 17.5 points
• Three risk categories for 30-day life expectancy probability
• Integration of objective data with clinical judgment

While more complex than other tools, the PaP can offer detailed prognostic information when laboratory testing is available.

Clinical Applications of These Tools

Initial Assessment and Diagnosis

When patients first enter hospice care, prognostic tools help establish a baseline functional status. This initial assessment can guide the development of comprehensive care plans and help families understand the expected care journey ahead.

Ongoing Monitoring and Evaluation

Regular reassessment using these tools helps track changes in patient condition over time. Declining scores may indicate the need for increased support services or transitions in care focus.

End-of-Life Care Planning

As prognostic scores indicate shorter timeframes, care teams can adjust interventions accordingly. Families receive support to prepare emotionally and practically for their loved one’s final days.

Supporting Your Family From Beginning to End

Prognostic tools can provide invaluable guidance for hospice care teams, but they represent just one aspect of compassionate end-of-life care. These assessments help ensure your loved one receives appropriate medical attention while maintaining dignity and comfort.

At Shiloh Hospice, our experienced team uses prognostic tools alongside personalized care planning to support patients and families throughout the hospice journey. We understand that each person’s experience is unique, and we’re here to provide the compassionate support your family needs.

If your loved one could benefit from hospice care services, contact Shiloh Hospice today to learn how our comprehensive approach can bring comfort and peace to your family during this difficult time.