1-800-328-5446 info@twinlakeshospice.com


General Guidelines for Admission


  • Life-limiting condition with prognosis of six months or less if disease progression runs its normal course
  • Patient/Family informed that condition is life-limiting and have elected comfort/palliative care instead of curative care.
  • Signs that disease process is progressing
    • Frequent hospitalizations
    • Progressive weight loss (taking into consideration swelling)
    • Increasing weakness
    • Fatigue
    • Sleeping more
    • Confusion
    • Weakness, unable to help self, Deteriorating mental abilities
    • Frequent infections, Skin breakdown
    • Specific decline in condition


  • Pulmonary Disease
  • Symptomatic at rest
    • Fast breathing
    • Shortness of breath
    • Fast heart rate
  • Oxygen dependent
  • Fluid in the lungs
  • Increased shortness of breath upon exertion (change from prior level of function)
  • Increasing blueness of lips and hands
  • Progressive cough
  • Anxiety
  • Unintentional weight loss
  • Cardiac Disease
    • Signs and symptoms of CHF at rest
      • Shortness of breath
      • Sweating
      • Skin and bones
      • Moist lungs
      • Alteration in heart sounds
      • Enlarged liver
      • Edema
      • Sporadic nighttime
      • Shortness of breath
      • Weakness
    • Frequent medication adjustments
    • Shortness of breath lying down and dizziness
    • Increasing chest pain – duration and/or frequency
    • Pale or ashen skin color
    • Increased symptoms
    • Ejection fraction < 20% (only if test results available)
  • Neurological Disease
    • General signs and symptoms of some neurological conditions/diseases including but not limited to Alzheimer’s, other dementias, Parkinson’s, Multiple Sclerosis, Amyotrophic Lateral Sclerosis (ALS), and Huntington’s disease
    • Increased weakness and unable to care for self
    • Signs of bulbar involvement: increased trouble swallowing, talking, and breathing
    • Difficulty or inability to speak
    • Nutritional impairment with current episodes of aspiration pneumonia and weight loss
  • Alzheimer’s Disease
    • Limited intelligible speech or inability to speak
    • Inability to ambulate or sit up independently
    • Unable to smile
    • Social Isolation
    • Repeated infections
    • Progressive weight loss, unable to swallow effectively Low protein and serum albumin levels
    • Difficulty or inability to hold head up independently
    • Score of three or less on Mini Mental State Exam
    • Skin breakdown
    • Urinary and bowel incontinence
  • Aids Criteria
    • Must have established AIDS diagnosis
    • Decision has been made to forego antiretroviral, antibacterial, antifungal, chemotherapeutic and prophylactic drug therapy related specifically to the AIDS diagnosis.
    • Chronic, persistent diarrhea
    • Significant weight loss of 10% or more in past three months
    • Generalized weakness
    • Persistent serum albumin < 2.5, Viral load > 100,000 copies ml, CD4 count < 50
    • History of frequent opportunistic infections
  • Liver Disease
    • Not a candidate/does not desire liver transplantation resection
    • Enlarged liver Jaundice
    • Abdominal Swelling
    • Malnutrition, Muscle wasting
    • Weakness and unable to care for self
    • Decreased urination
    • Recurrent variceal hemorrhage (vomiting blood)
  • Renal Disease
    • Creatinine clearance of < 10cc/mn (< 15cc/min for diabetics AND serum creatinine > 8.0 mg/dl (> 6.0mg/dl for diabetics))
    • Uremia
    • Nausea/vomiting
    • Itching
    • Restlessness
    • Urine output of < 400cc/24 hours
    • Uncorrectable fluid overload
    • Uncorrectable potassium level > 7.0 mEq/L
    • Uremic pericarditis, Hepatorenal syndrome
    • Patient has chosen not to have renal dialysis
  • Stroke
    • Recurrent infections
    • Recurrent ministrokes
    • Poor nutritional status
    • Skin breakdown
    • Paralysis
    • Post stroke dementia
    • Age typically > 70 years
    • Comatose with any five of the following on Day 3 indicate poor long term survival (97% mortality rate within two months)
      • Abnormal brain stem response
      • Withdrawal response to pain is absent
      • Age > 70 years
      • Verbal response absent Tahoma
      • Serum creatinine > 1.5mg/dl

Medicare Certified & Free-Standing

We are Medicare Certified, so you don't have to worry about your loved one's care being covered.


We focus on patients, not profits. The need of the patient and family members dictate what we do, not the need to be profitable.

Service Area

Twin Lakes Hospice was established in 1985 and serves all of Benton and Henry and St Clair counties and portions of Bates, Cass, Pettis, Johnson, and Hickory counties.  

Central Office

Our central office is located in Clinton at 725 E. Ohio Street.  Office hours are Monday through Friday from 8:00 a.m.- 4:30 p.m. There is a nurse on call after hours and on weekends for patient emergencies. 

Get In Touch


If you or a loved one have questions about our services and qualifications, please fill out the contact information and a Twin Lakes Hospice representative will be in contact with you. 


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