Essential Component 4
There is early recognition that a person
may be approaching or reaching the end of life

There is early recognition that a person may be approaching or reaching the end of life

Why is this an Essential Component?

Evidence for inclusion

Earlier recognition that a person may be approaching the end of their life provides both clinicians and patients and their families opportunities to establish their goals of care and to plan for their changing care demands into their future. This also allows for earlier consideration of approaches to care that focus on improved quality of life. Improved satisfaction with care, quality of life, physical and psychological symptoms and health service utilisation are all documented benefits of this approach to care (El-Jawahri et al, 2011; van der Steen et al, 2014; Temel et al, 2010; Zimmerman et al, 2014).

Earlier recognition also increases capacity to improve support to carers and families, especially where the patient’s goals of care include remaining at home.

Intended beneficial outcomes

  • Clinical staff are aware of the range of standardised screening tools that are available and these tools are used.
  • Clinical staff can identify those people who may benefit from integrated care as they approach the end of life.
  • Conversations about goals of care commence earlier to optimise opportunities to align care to those goals.
  • There are earlier opportunities for advance care planning.
  • There is additional time to guide healthcare delivery to prioritise quality of life for patients, their families and carers.
  • Partnerships are built with other services to provide multidisciplinary and cross-sectoral care which achieves goals of care.
  • There are enhanced opportunities for liaison and coordination with other specialists and services.
  • Patients, families and carers are informed and educated about the expected course of the patient’s illness and can plan appropriately.
There is early recognition that a person may be approaching or reaching the end of life

What tools/resources could support the implementation of this component?

The Agency for Clinical Innovation commissioned CareSearch (Palliative and Supportive Services, Flinders University) to identify local, national and international tools or resources that can potentially be used to implement each of the ten (10) Essential Components of Care within the Blueprint.

To be included, tools and resources were required to be in English, be applicable to the Australian context and be supported by evidence (such as published validation studies, clinical guidelines representing expert consensus, or advice from expert clinicians who were consulted).

The set of tools and resources provided is not intended to be exhaustive, nor is any one tool specifically recommended. Click here for more information on the methodology adopted by CareSearch in identifying these tools and resources.

Core Palliative Care Tools

Core Resources

  • Assessing and Managing Symptoms
    Australian Government funded PCC4U learning resource focusing on life-limiting conditions and their associated differential patterns of illness referred to as illness trajectories.
    Registration or payment is not required but permission is required to reproduce (eg in publications)

Evidence Check

The ACI Palliative Care Network commissioned an Evidence Check to identify and review tools to aid clinical identification of end of life. The Evidence Check sought to identify populations and settings in which clinical assessment tools could be used; barriers and enablers to their implementation and to develop a better understanding of the relevant and potential applicability of the tools in the NSW context.

Evidence Check:  Tools to aid in clinical identification of end of life

Disclaimer: This Evidence Check has identified a growing body of work supporting the development of tools to aid clinical identification of end of life. It is important to acknowledge that prognostication is an inexact science, and the tools identified are clinical aids rather than the answer to the question of specific prognostic accuracy.