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What You Need To Know about the PPS Scale (Palliative Performance Scale)

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Hospice can be a very challenging time for patients and their families, and it’s important to have a clear picture and accurate information as you walk through the journey ahead. In hospice, we use something called the Palliative Performance Scale (PPS). This evaluation tool helps us to assess and meet the care needs of patients in palliative care (specialized medical care for patients with a serious disease). 

So what is the PPS scale? 

How is it used by hospice healthcare professionals?

And why is the PPS important for making sure a patient gets the best care and support?

The PPS Scale: What Is It?

The Palliative Performance Scale (PPS) is a standardized assessment tool for evaluating a patient’s physical abilities and need for assistance. It measures how well a patient is able to get around and perform daily activities on a scale from 0% to 100% (increasing in 10% increments). Here’s an overview:

PPS LevelLevel of Activity and Self-Care Ability
100%Fully ambulatory (able to walk around) and able to perform normal activities without any limitations.
90%Fully ambulatory, but experiencing minor symptoms of illness.
80%Fully ambulatory, but requiring some effort to carry out normal activities.
70%Reduced ambulation, unable to work, but able to care for personal needs.
60%Ambulatory with assistance; significant disease present.
50%Mainly sitting or lying down; considerable assistance required.
40%Mainly bed-bound; requires extensive assistance.
30%Totally bed-bound; needs complete care.
20%Confined to bed, minimal responsiveness.
10%Near death, completely unresponsive.
Cropped view of an African-American nurse with a patient on the PPS scale.

How Do We Use the PPS Scale?

Assessment and Monitoring

As hospice professionals, we use the PPS to evaluate a patient’s current level of function — and to monitor the changes over time. During the first assessment (and those that follow), we make note of the patient’s PPS score. Using this score, we create a comprehensive picture of the patient’s health status and can add interventions and tailor care as needed.

Determining Eligibility for Hospice Services

Another important way the PPS is used is for determining an individual’s eligibility for hospice. Generally speaking, a PPS score of 70% or lower could signal that a patient is eligible. Insurance providers (including Medicare) frequently require certain PPS scores in order to authorize services. This information makes sure that patients receive the level of care they need — at the appropriate time.

Use in Forming Care Plans

The PPS scale assesses a patient’s physical functionality, but it also helps us (as hospice providers) to create an appropriate plan of care that supports their specific needs. For instance, if a patient’s PPS score is 50 percent, we know that they’ll likely need a lot of assistance with their daily activities. Knowing this information, we can provide more extensive support in their personalized care plan.

Why Is the PPS Scale Important?

Providing Personalized Care

Every patient is different. And at Envision, we strive to provide care that meets those unique needs. 

The PPS helps us understand an individual’s physical abilities and limitations. When we understand those needs, we can craft a care plan that provides the right level of intervention and support. From pain and symptoms management to emotional and spiritual support, personalized care meets each patient’s specific needs. And by using the PPS, we can make sure they are as independent and comfortable as possible.


The PPS scale gives healthcare providers, patients, and their loved ones a “common language” to talk about the patient’s condition and care needs. During hospice, open, clear communication is vital. The PPS helps everyone set realistic expectations for the hospice process and make informed decisions about treatment and care goals.

Prioritizing Quality of Life

Hospice care is all about prioritizing quality of life. Using the PPS, we can keep an accurate pulse on the patient’s status and proactively address symptoms. And by taking a proactive approach to pain and symptoms management, patients are empowered to spend their remaining time in the way that matters most to them.

Supporting Families

Here at Envision, we understand that hospice care impacts a patient’s loved ones, too. We’re passionate about providing the education and support families need while they walk through this journey. The PPS scale is a way that we can provide objective information that informs compassionate, personalized care. The PPS can help families understand the patient’s condition — and have realistic expectations as their loved one’s disease progresses. This information can actually be very comforting and help patients and families prepare and cope with the changes ahead.

At each stage of the hospice journey, we’re here to provide the support and care you need.

Shot of an adorable little girl playing with her grandpa who’s functional on the PPS scale.

The PPS Scale and Envision’s Commitment to Excellence

Here at Envision Hospice, we’re committed to providing the best comprehensive care for patients facing serious illness. We’re here to meet needs, empower patients and their families with information, and help them make the most of each moment. By using tools (like the PPS), we provide personalized and appropriate care that prioritizes a patient’s comfort. And during each step of the hospice journey, Envision will walk with you.

Do you have questions about hospice or the Palliative Performance Scale? Contact Envision today to learn more about our services with a free consultation.

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