Editor:  Janice Yeung

Contributor:  Alix Dumitrescu

Reviewed:  Bridget Johnson

 

In a hurry? Make sure you know

  • Current symptoms
  • A quick summary of the disease trajectory e.g. in oncology patient stage of cancer and recent progression of disease from imaging, in renal patient recent eGFR changes
  • Is this consult for symptom control, family support, community palliative care link up or terminal care?

 

What history should JMOs know/collect?

  • All current symptoms
  • Family dynamics
  • Social situation – where and with whom do they live?
  • Does the patient have an Advanced Care Directive?

 

What examination and investigations should JMOs perform/order?

  • Targeted physical examination surrounding symptoms eg: check the quality of bowel sounds in suspected bowel obstruction.
  • Know when the last progress imaging was performed and what it showed in an oncology patient. Know the eGFR trends and most recent results in a patient with chronic renal failure. Know the relevant poor prognostic blood or imaging results in a general medical patient.

 

What additional information would impress you?

  • Knowing what the patient has been told and what they understand their prognosis to be
  • Knowing who is their next of kin or enduring guardian is as they will be the surrogate decision maker

 

What are common mistakes/omissions made by JMOs?

  • Not having all the information prepared before making the referral
  • Not informing the patient that their home team consultant has requested the palliative care team to be involved in their care. We are far better able to build rapport with the patient if they know that the admitting team consultant has asked for us to be involved

 

Helpful resources

Website:  Palliative care Australia

It is good to give the website address to the patient and their family if they have any questions about palliative care or advanced care directives. This website also contains a number of helpful brochures about palliative care that can be printed off for families who don’t have access to the internet. This website also contains a directory of palliative care services around Australia, which can be very helpful if you are caring for a patient who lives outside of your hospitals local area.

 

onthewards podcasts

Palliative care with Bridget Johnson

End of life care with Imogen Mitchell