1. The patient’s mild or moderate, intermittent or permanent loss of cognitive or physical ability for independent self-care as observed or acknowledged by the patient
2. Change in the patient’s role, family structure or potential care network (e.g. childbirth, divorce, employment status change or death)
3. Unrelieved psychological, social or spiritual distress (expressed or observed)
4. The patient or family asking about the dying process
5. Stressors related to financial planning for the future
6. Pain associated with chronic or progressive disease process that is unrelieved after 48 hours
7. Management of advanced symptoms such as fatigue, nausea, loss of appetite, loss of skin integrity, dysarthria, increasing upper extremity weakness, decrease in sexual function
8. Repeated urinary tract infections, aspiration pneumonia, or other infections leading to repeated hospitalization
9. Bowel incontinence
10. Dysphagia warranting a feeding tube or causing weight loss, cachexia and/or anemia
11. Dyspnea or symptoms of hypoventilation requiring non-invasive or invasive ventilation
12. Depression and/or suicidal ideation
13. Verbal or non-verbal cues to unspoken concerns (e.g. “I’m coping with it the best I can,” or the patient begins to cry during the interview)
For more details on Palliative care treatment call
PallEx Healthcare c/o Deccan Hardikar Hospital, 1st Floor, University Road, Shivajinagar, Pune-5 on 020-41095000 / 020-41095002