Assistance with complex symptom management
- Managing escalating or refractory symptoms (eg, pain, dyspnea, and nausea)
- Complex pharmacologic management in patients facing a life-limiting illness (eg, opioid infusions, opioid rotations, patient-controlled analgesia, methadone initiation, and ketamine initiation)
- Addressing complex depression, anxiety, grief, and existential, spiritual, or psychosocial distress
- Respite and/or palliative sedation for intractable symptoms
Care of complex, severely ill patients over time
- New diagnosis with metastatic cancer and/or malignancy with high symptom burden
- Frequent hospital admissions for the same diagnosis of a serious illness
- Intensive care unit admission with metastatic cancer
- Intensive care unit admission with poor prognosis
- Prolonged intensive care unit stay
Assistance with medical decision making and determining goals of care
- Discussing transitions in care
- Complex and/or evolving goals of care discussions
- Assistance with conflict resolution regarding goals or methods of treatment, whether that conflict is within the family, between the family and the medical teams, or between treatment teams
- Redefining hope, in the setting of complex illness
- Complex code status discussions
- Assistance with managing patient and/or family conflict or complex social issues
- Ethical dilemmas
Questions regarding future planning needs
- Determining and discussing prognosis, where desired
- Care and planning in the setting of advanced illness
- Consider referral when one would answer “yes” to the question, “Would I be surprised if my patient died within 12 months?”
- Discussing issues pertaining to artificial feeding or hydration
- Determining present and future care needs
- Help with determining hospice eligibility and providing hospice education
SourceTop 10 Things Palliative Care Clinicians Wished Everyone Knew About Palliative Carehttps://www.mayoclinicproceedings.org/article/S0025-6196(13)00452-7/fulltext#sec1
