Assess

PALLIATIVE APPROACH INDICATED?

Would I be surprised if this patient died in the next 6-12 months?

Even if your answer is yes, patient can always benefit from advance care planning. See Communication section.

If no, look for one or more of general indicators

General indicators >1

  • poor or deteriorating status (limited self-care, in bed or chair over 50% of the day)
  • history of multiple hospitalizations in the last 6 months
  • need for more care at home (or is already in long term care facility)
  • multiple comorbidities causing symptoms or functional decline
  • progressive weight loss; remains underweight; low muscle mass.
  • persistent symptoms despite optimal treatment of underlying condition(s).
  • Patient requests palliative approach

Disease-specific indicators >2

Cancer

  • increasing age
  • serum calcium >2.8mmol/l
  • DVT or PE
  • brain mets or CNS involvement in hematological malignancies
  • spinal cord compression
  • malignant pericardial effusions
  • serum albumin <35 mmol/l

too frail for cancer treatment or treatment is for symptom control.

COPD

  • body mass index <21
  • severe airway obstruction (FEV1<30%) or restrictive deficit (vital capacity <40%)DLCO<40%
  • persistent breathlessness at rest or on minimal exertion despite optimal tolerated therapy (exclusive of exacerbation)
  • persistent hypoxia needing long-term oxygen therapy.comorbidities of symptomatic heart failure or obstructive sleep apnea
  • increased emergency admissions for infective exacerbations and/or respiratory failure
  • Needed ventilation for respiratory failure or ventilation is contraindicated.

Dementia

  • increasing age
  • male gender
  • dyspnea
  •  recurrent febrile episodes or infections, aspiration pneumonia, pressure ulcers
  • low oral intake/weight loss/BMI <18.5

Frailty

  • age >75
  • serum albumin <35
  • unable to do self-care (ADL) without help
  • progressive weight loss(weight loss >10%)
  • low muscle mass
  • creatinine >265 mmol/l
  • delirium

Heart failure/vascular disease

  • NYHA class III/IV heart failure because of valve disease or coronary artery disease not amenable to surgery/angioplasty
  • ejection fraction severely affected (<30%) or severe pulmonary hypertension (>60 mm Hg)
  • persistent symptoms (breathlessness/chest pain) despite optimal tolerated therapy
  • renal impairment (eGFR <30 ml/min)
  • cardiac cachexia: progressive loss of lean body mass, reduced muscle strength, anorexia, fatigue
  • markers of chronic inflammation/cachexia anemia: hemoglobin <115, uric acid >565, albumin <32
  • Severe, inoperable peripheral vascular disease.

HIV/AIDS

  • incurable CNS lymphoma
  • viral load on maximal therapy >10,000
  • poor performance status
  • organ failure
  • other life-limiting co-morbidities

Liver failure

  • age >50
  • stage Child C, MELD-Na Score >30
  • advanced cirrhosis with one or more complications in the past year: diuretic resistant ascites; hepatic encephalopathy; hepatorenal syndrome; bacterial peritonitis; or recurrent variceal bleeds.
  • liver transplant not possible.

Renal failure

  • age >80
  • stage 4 or 5 chronic kidney disease (eGFR < 30ml/min) with deteriorating health.
  • albumin <35
  • peripheral vascular disease or vascular dementia
  • dementia
  • kidney failure complicating other life-limiting conditions or treatments.
  • not starting dialysis.

Stroke

Acute

  • large volume of brain affected or brain stem
  • Increasing age
  • Comorbidities
  • Function prior to stroke

Chronic

  • Degree of disability
  • Comorbidities
  • Dysphagia causing aspiration

Neurodegenerative diseases

  • Age > 75
  • Low FVC – respiratory muscle weakness
  • Swallowing difficulties &/or poor nutritional status
  • Medical complications e.g. aspiration pneumonia, sepsis
  • Cognitive impairment
  • Rapid spread from onset region to other region — ALS
  • Medications less effective — Parkinson’s

If not surprised and patient has general and disease-specific criteria – patient benefits from palliative approach

Talk tip: “We can’t cure your disease, but our goal is to help you live as well as you can for as long as you can.”

Talk tip: ”Although we do not have any further treatments to reverse the disease, there is always something we can do to help you feel better.”