Quiz: Hospice or Palliative Care Quiz: Hospice or Palliative Care If four or more of the following apply, hospice may be the answer for you or your loved one. Have you been informed by physician of limited life expectancy? Yes No None Have you had several hospitalizations or visits to the emergency room over the last six months? Yes No None Have you increase your medication for physical pain? Yes No None Have you had several falls within the last six months? Yes No None Have you made frequent phone calls to physicians’ office? Yes No None Is the majority of day spent in bed or chair? Yes No None Do you require assistance with two or more of the following: getting out of bed, bathing, dressing, walking, eating? Yes No None Do you have a noticeable shortness of breath, even at rest? Yes No None Do you feel more tired and weaker overall? Yes No None Have you experienced dramatic weight loss, are your clothes noticeably looser? Yes No None Please enter your contact information and someone from our team will reach out to you based on your results. Name Phone Email Time's up
