HOPE Guidance Manual v1.02, Section J: Health Conditions

Section Intent

Items in this section are intended to document the physical symptoms and the impact of pain and non-pain

symptoms for hospice patients. The items in this section include an assessment of imminent death, screening for

pain, a comprehensive pain assessment if warranted, and screening for dyspnea. The items are intended to

incorporate information from the interview with the patient and family/caregiver, as well as the clinical

assessment and judgment of the assessing nurse if the patient is unable to participate.

Section Rationale

Pain and non-pain symptoms (such as shortness of breath) are prevalent and undertreated for many populations

of seriously ill patients, including those nearing the end of life.

Patients and family/caregivers rate pain management as a high priority when living with serious and life-limiting illnesses. Other non-pain symptoms can be functionally limiting and distressing to patients, as well as

to their families/caregivers.

The consequences of inadequate screening, assessment, and treatment for these conditions can impact the

patient by causing physical suffering, social withdrawal, depression, and functional decline.

Screening for pain and non-pain symptoms and their impact on the patient will assist the hospice team with care

planning and is an essential step for effective symptom management and treatment.

Effective treatment is available to alleviate and lessen the impact of most pain and non-pain symptoms.

Treatment may include pharmacologic and non-pharmacologic interventions and will vary based on patient and

family/caregiver preferences.

Note: Examples combining items J0900, J0905, and J0910 can be found at the end of the item guidance for

J0910.