Indications for Palliative Consultation

Not just for patients with cancer

The following criteria should be considered as criteria for initiating a palliative care referral.

Ask yourself, "Would I be surprised if this patient died in the next year?" If the answer is "yes," then consider a palliative consultation.

Patients with advancing dementia, end-stage renal failure, end-stage liver failure, congestive heart failure, advanced lung disease, advanced ALS/MS, have palliative needs
Frequent emergency room visit for the same diagnosis
Frequent hospital admissions for the same diagnosis in the last 30 days
Prolonged hospital or ICU stay (7-14 days) without evidence of improvement
Declining ability to complete activities of daily living
Difficult to control physical or emotional symptoms
Patient or family needs help making complex care decisions
Physician needs support with difficult conversations about prognosis