When is a referral to palliative care appropriate?
A referral to Specialist Palliative Care (SPC) is appropriate for the direct management/support/advice of patients and families/whanau in situations where there are complex palliative care needs.
A referral to Specialist Palliative Care for “complex need” emphasizes that this is a level of need that exceeds the resources of the generalist team and may be in any of the domains of care – physical, psychological, spiritual, social, or intellectual.
A referral to Specialist Palliative Care is appropriate when:
- The patient has unrelieved physical symptoms relating to their illness.
- The patient and/or family/whanau has unresolved psychological, social, spiritual or religious concerns.
- The patient and/or family/whanau need additional support, reassurance or assistance during a period of crisis.
- The patient has complex or distressing emotional or behavioral difficulties related to the illness.
- The patient has complex social issues involving children, family or carers (this may include the physical and/or human environment, finances, communication, learning disabilities, etc.).
- The patient has issues around self worth, loss of meaning and hope (may include requests for euthanasia, as well as other ethical dilemmas).
- The patient has symptoms that are difficult to manage in the context of advancing organ failure and/or medication delivery problems.
- It is anticipated that the patient will have complex needs within the community setting on discharge from hospital that require SPC expertise around discharge planning.
It should be noted that many patients may still be receiving active treatment for their underlying disease process; the Palliative Care Team will work alongside the referring team to ensure that both symptomatic management and support is maximized. On occasions a member of the SPC may be asked to assist with psychological/ emotional support for the primary clinical team (such as de-briefing) and this would be done on an as-needed basis.
See the Referral Criteria for Adult Palliative Care Services in New Zealand.
Topic Code: 11340