Hospice & Palliative Care

Lower Cape Fear Hospice adds care experts to your team to facilitate care.

We are…

  • The only hospice in the region with full-time physicians on staff
  • Our clinical team are experts in pain and symptom management: nearly 60% physicians, 40% nurses, and 10% of aides have earned their Certification in Hospice and Palliative Care
  • New Hanover Regional Medical Center (NHRMC) and Brunswick Health Novant Medical Center (BHNMC) choose LCFH as their quality partner to provide palliative care to their patients.

Our Services

While both hospice and palliative care provide comfort and pain relief, palliative care can begin at the time of diagnosis, and is primarily focused on pain and symptom relief. Hospice care begins when the current prognosis indicates a life expectancy of six months or less, or treatment is no longer available or desired.

Refer a patient for hospice or palliative care by filling out this form or calling our Physicians Resource Center at 800.207.6908.

Partnering with you in your patient’s last months to ensure that quality of life and care continue.

When your patient is approaching the end of life, we are there when you can’t be to make sure quality of life and care continue. Our interdisciplinary teams provide expert care and family support, and devote the time needed to prepare them for what’s next. Our care also extends to the patient’s family and loved ones by providing  education and grief counseling.

When are patients eligible for hospice?

Patients are eligible for hospice care when the determination is made that life expectancy is six months or less if the disease follows its usual course. Patients eligible for hospice show decline in status in combination with objective indicators of disease progression.

This guide is a reference to factors that indicate life expectancy may be six months or less.

Decline in Status
    • Increasing hospitalizations, ER or physician visits
    • Recurrent serious infections (i.e. pneumonia or sepsis)
    • Progressive weight loss, malnutrition
    • Dysphagia leading to recurrent aspiration
    • Dyspnea, increased respiratory rate, cough
    • Nausea, vomiting, and diarrhea
    • Pain requiring increasing doses of analgesics
    • Systolic BP < 90 or progressive postural hypotension
    • Ascites, edema, or effusions
    • Changed level of consciousness
    • Progressive stage 3-4 pressure ulcers
    • Albumin <2.5 gm/dl
    • Feeding
    • Ambulation
    • Continence
    • Transfers
    • Dressing
    • Bathing

Also significant in determining eligibility:

  • Reduced performance status (as evidenced by reduced PPS/Karnofsky/ECOG)
  • Comorbid conditions yielding a high overall burden of illness
Disease Specific Indicators
    • Includes: Alzheimer’s, senile dementia, Lewy Body, Parkinson’s, vascular and other dementias
    • Impaired ambulation, speech, continence
    • Aspiration pneumonia, recurrent UTIs
    • Decubitus ulcers, weight loss, frequent falls
    • Disabling dyspnea at rest, fatigue and cough from COPD, pulmonary fibrosis, pulmonary HTN
    • Hypoxemia at rest, right heart failure, resting tachycardia, unintentional progressive weight loss
    • Examples: Parkinson’s disease, ALS, Multiple sclerosis, Huntington’s chorea, muscular dystrophy, past stroke or chronic ischemic cerebrovascular disease
    • Impaired respiratory function, impaired swallowing
    • Severe nutritional deficiency, Alb <2.5 gm/dl
    • May have symptoms of dementia as above (i.e. weight loss, pressure ulcers)
    • May have history of MI, resuscitation, arrhythmias, embolic infarcts, syncope, inoperable valvular heart disease, CHF
    • Treatment resistant angina or not a candidate for invasive revascularization procedures
    • NYHA Class III or NYHA Class IV symptoms
  • Patients eligible or awaiting transplant may be considered for hospice services.

    • Albumin <2.5 gm/dl, INR > 1.5
    • Refractory ascites, peritonitis, hepatorenal syndrome, hepatic encephalopathy, or variceal bleeding
    • CD4+ count < 25 cells/mcL (or)
    • Persistent viral load >100K copies/ml (and)
    • PPS < 50% with AIDS defining infection
    • Cr clearance < 15 cc/min
    • Creatinine > 8 mg/dl (or >6 if diabetic)
    • Patient is not seeking dialysis, plans to discontinue dialysis, or can no longer tolerate dialysis
    • Comorbidities support eligibility
    • Stage III b or Stage IV Metastatic disease
    • Treatment refractory myeloproliferative disorders
    • Continued decline despite disease directed treatments, or patient declines treatment
Make a referral for hospice care by filling out this form or calling our Resource Center at 800-207-6908.

Palliative care is different from hospice care.

One in four Americans has multiple chronic conditions such as:

  • Heart disease
  • Diabetes
  • COPD
  • Cancer
  • Dementia
  • Renal disease

Once someone has reached the age of 65 or older, this figure increases to three in four. Palliative care can help.

Your patients and team gain palliative care experts to help facilitate goals of care, improve communication, foster patient satisfaction, and improve quality of life for your patients and their families.

It’s available at time of diagnosis while curative treatment is still ongoing.

Our palliative care services provide for coordination of care and improved quality of life through pain and symptom management. Palliative care patients are visited by a nurse practitioner once (sometimes more often) during the month to access needs and provide care.

    • Eases pain and symptoms; prevents crisis
    • Results in fewer hospitalizations and for those hospitalized, a shorter stay
    • Decreases hospital readmissions
    • Helps, supports and improves coordination of care among patients, family and providers
    • Assists with discussions about goals of care
    • Provides information and support on advance care planning
    • Pain
    • Nausea
    • Vomiting
    • Breathing difficulties
    • Fatigue
    • Confusion
    • Depression
    • Uncontrolled symptoms and comorbidities
    • Complicated family dynamics
    • Frequent trips to the hospital or ER
    • Need for defining goals of care or advance directives
    • Retirement communities
    • Assisted living facilities
    • Skilled nursing facilities
    • Hospitals
    • Private homes

Refer a patient for palliative care by filling out this form or calling our Physicians Resource Center at 800.207.6908.

Together we make a difference.

We are very fortunate to have worked with hundreds of knowledgeable physicians who are dedicated to the best interest of their patients and the community. We encourage you to consult with your Lower Cape Fear Hospice provider representative or call 800-207-6908 to speak with someone at our office. We will be glad to discuss what kind of care would be the best option for your patient.


“Our lives changed from the moment we spoke to the first person from Lower Cape Fear Hospice. They take care of everyone in the family with love and respect. In a really hard period of life, hospice brings dignity, peace, understanding, caring and respect. Thanks for being there for us and especially for our loved one.”

Son of hospice patient

Quality Counts

Lower Cape Fear Hospice ranked 84 percent in the category of “getting timely help,” as rated by caregivers on a hospice quality survey. The national average is 78 percent. New Hanover Regional Medical Center, Novant Health Brunswick Medical Center, Columbus Regional Healthcare System, and more than 40 assisted living and skilled nursing facilities, partner with Lower Cape Fear Hospice to provide palliative care to their patients.

Don’t Wait

Only 10% of our patients take advantage of the full Medicare hospice benefit which includes ALL medical care, medications, equipment and visits related to diagnosis.

To find out if you or someone you love qualifies for hospice, call 800.733.1476 or fill out the below form:




Lower Cape Fear Hospice is a nonprofit organization dedicated to providing the highest level of care and comfort to patients with life-limiting illness; support and counseling to families; and education to the community.


FAX:  910.796.7903


Lower Cape Fear Hospice
Home Office
1414 Physicians Drive
Wilmington, NC 28401
910.796.7900 or 800.733.1476
FAX: 910.796.7901

Lower Cape Fear Hospice
Mercy Care

8216 Devon Court
Myrtle Beach, SC 29572
FAX: 843.848.6655


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