write up based on 8 domains of hospice palliative care

The goal is to produce a comprehensive assessment and plan for a patient with a serious illness who may be in their last few years of life.

Document core clinical information in traditional format.

Write assessment and plan based on 8 domains of hospice palliative care … see section ‘Overview of comprehensive patient assessment in palliative care’ in UpToDate …

8 Domains of Hospice & Palliative Care

Structure and Processes of Care – interdisciplinary team assessment based on patient/family goals of care; prognosis; disposition (hospice level of care – inpatient unit, home); safety

Physical Aspects of Care – pain, dyspnea, n/v, fatigue, constipation, other; performance status; medical diagnoses; medications (add/wean/titrate)

Psych Aspects of Care – anxiety, depression, delirium, cognitive impairment; stress, anticipatory grief, coping strategies; pharm/non-pharm rx; pt/fam grief/bereavement;

Social Aspects of Care – family/friend communication/interaction/support; caregiver crisis

Spiritual Aspects of Care – spiritual/religious/existential; hopes/fears; forgiveness;

Cultural Aspects of Care – language, ritual, dietary, other.

Care of the Imminently Dying – presence; recognition and communication to pt/fam; education/normalization; prognosis (eg hours to days; very few days; etc)

Ethical & Legal Aspects of Care – decision maker; adv dir; and/dnr; manh; abx.

These serve as an excellent framework for an approach to the patient/family, documentation, and other communication.

Guidelines for Quality Palliative Care