Certificate of Terminal Illness

John Doe, a 78-year-old male, has been diagnosed with advanced pancreatic cancer. He also suffers from chronic obstructive pulmonary disease (COPD) and hypertension. His past medical history includes a myocardial infarction and type 2 diabetes. Recently, John has moved to a hospice facility due to increased care needs. He has experienced significant cognitive decline, exhibiting confusion and memory loss. His medication regimen has been adjusted to manage pain and anxiety. John has had three falls in the current benefit period and two in the previous one. His oral intake has decreased from 50% to 30% of his usual diet. His weight has dropped from 160 lbs to 145 lbs, and his LMAC has decreased from 28 cm to 25 cm. John has developed new symptoms of persistent nausea and vomiting. His sleep duration has reduced from 8 hours to 5 hours per night. He is no longer able to engage in activities he once enjoyed, such as gardening. John requires assistance with mobility and uses a wheelchair. He needs help with 5/6 ADLs, including bathing, dressing, and feeding. His Palliative Performance Scale score has decreased from 40% to 30%, indicating a decline. It is my judgement that Mr. Doe is terminally ill with a life expectancy of 6 months or less if his condition continues to decline along its usual course.