End-of-Life Care for Patients Suffering from Liver Disease

Symptoms experienced by patients with end-stage liver disease (ESLD) may be well known to a physician, but determining hospice eligibility can be difficult, especially for patients eligible for transplant. The primary care physician or nephrologist will look at the patient’s condition in his totality and at the following clinical indicators that the patient has end-stage Patients liver disease:

Hospice Care for Patient suffering from Liver Disease San Diego
  • Prothrombin time prolonged more than 5 seconds over control, or International Normalized Ratio (INR)>1.5
  • Serum albumin
  • Ascites, refractory to treatment or patient non-compliant
  • Spontaneous bacterial peritonitis
  • Hepatorenal syndrome (elevated creatinine and BUN with oliguria (<400ml/day) and urine sodium concentration
  • Hepatic encephalopathy, refractory to treatment, or patient non-compliant
  • Recurrent variceal bleeding, despite intensive therapy
  • Progressive malnutrition
  • Muscle wasting with reduced strength and endurance
  • Continued active alcoholism (>80 gm ethanol/day)
  • Hepatocellular carcinoma
  • HBsAg (Hepatitis B) positivity
  • Hepatitis C refractory to interferon treatment

We at Aria Hospice understand that some clinical information presented to the patient’s family may not be a great help in making a decision for hospice care.  Please, call us when you have any specific question regarding eligibility for hospice and the type of services we offer for patients with liver disease.

When it comes to information regarding eligibility for hospice care, it can be overwhelming for some families, for example some families may not know that a patient awaiting liver transplant may be under hospice care until a donor organ is procured. The patient will just be discharged from hospice care at that time.

Also, if a patient has kidney failure, is on hemodialysis but has other body system(s) who are failing, the patient can be under hospice care at the same time the patient is under hemodialysis.

Aria Hospice’s mission is to serve those in the end stages of liver disease, to relieve pain, control symptoms, improve quality of life and reduce anxiety for patients and their families. Only a doctor can make a clinical determination of end-stage liver disease life expectancy. However, look for these common signs that the disease has progressed to a point where all involved would likely benefit from hospice services.

Signs it might be time for hospice

Considering the slow decline of a patient with liver disease, it can be difficult to determine when the time is right for hospice. In general, hospice patients are believed to have six months or less to live.

Not every patient with ESLD wants or is appropriate for a liver transplant. When symptoms become difficult to control and quality of life deteriorates, patients and their families and physicians should consider hospice.

When a patient is a not a candidate for a liver transplant or the patient’s transplant has failed and the patient is not eligible for, or refuses, another transplant, these are the typical signs that indicates the patient will benefit from Aria Hospice comfort measures/palliative care:

  • Sudden or progressive loss of functional independence
  • Weight loss or reduced appetite
  • Inability to work
  • Patient spends the majority of time sitting or lying in bed
  • Confusion, cognitive impairment
  • Abdominal distension
  • Malaise
  • Bowel dysfunction
  • Breathing difficulties
  • Itchy skin
  • Restlessness
  • Altered mood and behavior

Benefits of Aria Hospice Care for Liver Disease Patients

The Aria Hospice team will evaluate the patient’s medical status and revise their care plan as the patient’s condition and symptoms change. The goal of hospice care for liver disease patients is to treat pain and other symptoms and relieve the physical and emotional stress to ensure the greatest level of comfort for our patients and their families.

Pain Management – Aria Hospice Care team provides Comfort/palliative care which focuses on relieving pain and maintaining comfort.

Symptom Control – The Aria Hospice Care team regularly assesses each patient’s condition and works with the hospice Medical Director to determine the most effective treatment and medication options to maximize symptom control.

Coordinated care at every level – A plan of care is developed with the advice and consent of the patient’s physician, if available or Aria Hospice physician. The Aria Hospice Case Manager ensures that information flows between physicians, the visiting nurse, social worker and, at the patient’s request, clergy. In addition, Aria Hospice coordinates and supplies all medications, medical supplies and medical equipment related to the diagnosis to ensure patients have everything they need.

Emotional and spiritual assistance – Aria Hospice has the resources to help patients maintain their emotional and spiritual well-being.

We Listen. We Care. We Serve.

When you are faced with the challenge of finding a hospice provider to help care for the emotional and physical well being of someone you love, maybe your mom or dad, you will be faced with many questions.

Making the decision about hospice care for a loved one is never easy, but finding the right answers can help you feel more comfortable with the options available and confident in your final decision.

Aria Hospice operates hospice care programs throughout San Diego and Imperial Counties in Southern California. We pride ourselves on being one of the areas leading providers of end-of-life care.


Our Hospice Care Specialists are Here to Help

Call Us Today for Answers to End-of-Life Questions.


Anyone diagnosed with a limited life expectancy can receive Aria Hospice care.

Once a physician certifies that an illness is terminal, (a life expectancy of six months or less), they will collaborate with the Aria Hospice team for services, tailored to the needs and wishes of the patient.

Many patients have cancer, but Aria Hospice cares for individuals with many other life-limiting illness, including heart and lung disease, kidney disease, neurological disorders, stroke, Alzheimer’s and other dementias. Family and friends also receive the benefit of hospice care, to help them support the patient and adapt to changes in their lives.

Many people mistakenly believe that all hospice patients are bed-bound, critically ill, and unable to continue living life to the fullest. Hospice celebrates life and supports you in achieving your individual needs in this chapter of your life.

Contact our Admission Coordinator at Aria Hospice in San Diego County or Imperial County with any questions you may have about hospice care or eligibility.

who can receive hospice care


After receiving a diagnosis for limited life expectancy, patients must make an important choice about goals for their treatment.

why choose aria hospice care

When a physician determines that there is no curative treatment for a particular illness, the treatment is not helping any longer or you decide that the side effects of treatment are too great, you may consider choosing comfort care as your ultimate goal.

Aggressive medical treatment focuses on curing the physical illness rather than satisfying the patient’s emotional and spiritual needs. It often requires intensive care in a clinical setting that can diminish quality of life. Hospice care has the focus of comfort, by relieving pain and other symptoms, while continuing to address emotional and spiritual needs of both the patient and family.

Hospice care neither prolongs life nor hastens death, but relieves pain and physical discomfort so that the patient can experience a more peaceful and satisfying quality of life. At Aria Hospice, care is designed to primarily take place in the home or place of residence. Many families tell us that they waited too long to take full advantage of all the benefits offered by hospice care.


Our Team is Here to Help!

We are one of Southern California’s premier providers of end-of-life care. Click the button below to Request Information or call (619) 795-6010 to learn how hospice care can help.