Toolkit: Step 2 Assessment

Assess the person’s current and future needs and preferences across all domains of care. Include validated screening tools, an in-depth history, physical examination and relevant laboratory and imaging tests.

Screening Tools

Use validated screening tools to identify if the patient, their family or caregiver have any needs that require urgent intervention. Type and timeliness of screening will depend on the severity, urgency and complexity of the symptoms or needs identified.

Visit:

• Palliative Performance Scale, PPS, Functional Status, Victoria Hospice
• Palliative Prognostic Index, Morita T, Tsunoda J, Inoue S, Chihara S. The palliative prognostic index: a scoring system for survival prediction of terminally ill cancer patients. Supportive Care in Cancer 1999; 7: 128-33
• Clinical Frailty Scale, CFS, Functional Status, Geriatric Medicine Research, Dalhousie University
• Distress Thermometer and Problem List, National Comprehensive Cancer Network

Download:

• Edmonton Symptom Assessment System, ESAS, depression, anxiety, and wellbeing, Ontario Health (Cancer Care Ontario)
• Eastern Cooperative Oncology Group Performance Status, ECOG, National Palliative Care Research Centre
• Changes in health, End-stage disease and Signs and Symptoms (CHESS) scale and the Personal Severity Index (PSI), RAI-MDS

Holistic Assessment Tools

Assess the person’s current and future needs and preferences across all domains of care. Include validated screening tools, an in-depth history, physical examination and relevant laboratory and imaging tests.

Explore symptoms and needs across all domains in more detail through history and examination. Specific details on domains of issues associated with illness and bereavement are described in the Canadian Hospice Palliative Care Association’s Model to Guide Hospice Palliative Care . Continue to screen regularly for distress and other needs.

Visit:

• InterRAI Suite of Assessment Instruments, Includes Home Care, Palliative Care, Community Health Assessment, CHESS-MDS, DIVERT, eScreener
• Psychosocial Assessment, INCTR Handbook
• Patient Dignity Question, Dignity In Care
• Patient Dignity Inventory, Dignity In Care
• FICA Spiritual History Tool, GW School of Medicine & Health Sciences
• HOPE Questions for Spiritual Assessment, Anandarajah, G., & Hight, E. (2001). Spirituality and medical practice: using the HOPE questions as a practical tool for spiritual assessment. American family physician, 63(1), 81. See section on HOPE Questions

Conversation and Consent Tools

Assess the person’s current and future needs and preferences across all domains of care. Include validated screening tools, an in-depth history, physical examination and relevant laboratory and imaging tests.

Use the results of screening and assessment to prompt further discussions about a person’s wishes, values, beliefs, understanding of wellness and any illnesses, and goals for current and future care. These conversations are ongoing and should be revisited regularly.

Visit:

• A Clinicians Guide to Substitute Decision Making, Hospice Palliative Care Ontario
• Online Advance Care Planning Workbook, Hospice Palliative Care Ontario

Download:

• Person-Centred Decision-Making Resource for Healthcare Providers, Ontario Palliative Care Network
• Making Decisions About Your Care: Patient Resource, Ontario Palliative Care Network
• Advance Care Planning, Goals of Care, and Treatment Decisions & Informed Consent, Frequently Asked Questions, Ontario Palliative Care Network
• Approaches to Goals of Care, Ontario Palliative Care Network