Self-Evaluation Quiz Hospice can be a scary topic to discuss under any circumstances. With this point in mind, we developed a tool that can assist in decreasing the stress of having that crucial conversation. In quiet and comfortable surroundings, why not take the opportunity to discover whether or not, the topic should be broached with your physician and/or family? Take the following self-evaluation quiz and discover possible next steps based on your answers. Have you or your loved one… Started needing help from others with TWO or MORE of the following? Bathing Getting out of bed Eating Dressing Walking Yes NoBeen hospitalized or visited the emergency room several times in the past six months? Yes NoBeen making more frequent phone calls to your physicians? Yes NoStarted spending most of the day in a chair or bed? Yes NoBeen told by a doctor that life expectancy is limited? Yes NoFallen several times over the past six months? Yes NoStarted taking medication to lessen physical pain? Yes NoStarted feeling weaker or more tired? Yes NoExperienced weight loss so that clothes are noticeably looser? Yes NoNoticed any shortness of breath, even while resting? Yes No Blog Press Releases News Clips Videos Name* First Last Home Phone*Email* Service/Company*Service/CompanyPlease Choose OneGood Shepherd HospiceLifePath HospicePalliative CareChapters Health SystemHPH HospiceHPH Home HealthChapters Health Home ConnectGeneral EnquiryMessage*EmailThis field is for validation purposes and should be left unchanged.