Palliative care should be provided according to an individual's need and may be suitable whether death is days, weeks, months or occasionally years away. In most cases the patient's prognosis might be expected to be less than 1 year. Prognostic Indicator
Palliative care might be appropriate for those suffering from:
* although this is by no means a complete list.
The following questions might be appropriate to help determine the complexity of the palliative care required and therefore help determine if a hospice should be involved:
|Area of patient's experience||Suggested assessment question|
|Physical symptoms||What symptom bothers you most?|
|Pain||How much pain have you had in the last week?|
|Depression||Are you feeling depressed?|
|Financial||Is your illness causing much financial hardship to you or your family?|
How much help do you need with your personal care?
How much help have you needed from someone in your family?
|Social support||Is there someone you can confide in and talk to about yourself or your problems? How often is there someone to have a good time with?|
Do you have a faith?
Since your illness have you become more or less spiritual or religious?
|Hopes & expectations||Is there a something special, like an event, that would add a great deal of meaning to your life?|
|Advance care planning||Have you talked to your family, or anyone, about your preferences for medical care in case of a life-threatening situation?|
*References; Emanuel EJ, Emanuel LL. The promise of a good death. (review) Lancet 1998; 351 Suppl 2:SII21-
The Bay Navigator pathway offers GPs options to assist patients with many and varied aspects of care. If support is required in multiple areas it may be time to involve hospice services, as palliative care needs are being assessed.
At this stage it would be appropriate to consider Advance Care Planning for your patient
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