A proactive and systematic approach to symptom assessment can help anticipate patient clinical needs and support care management.
Consider which problems most affect the person’s quality of life (physical, emotional, social, spiritual). Many symptoms are multifactorial, or occur in clusters, and some causes may be more or less reversible than others.
Given the nature of this person’s disease, consider what problems may need to be planned for, and ensure that essential medications can be accessed when they are needed.
As the person’s condition deteriorates, they will lose the ability to swallow. This can be sudden, and planning can ensure that the individual’s symptoms continue to be managed. To avoid delays, e.g. over a weekend, it is advisable to write up the medication and ensure that it is available within a facility prior to its being needed. This pre-emptive action is referred to as anticipatory prescribing.
Safer Care Victoria has developed guidance on Anticipatory medicines in palliative care.
Consider using simple assessment tools such as the Symptom Assessment Scale (SAS),
Distress thermometer (167kb), or a pain diary (101kb pdf) to screen for and monitor symptoms. Check for adverse effects of treatments, as well as benefits, regularly.
Download the PCOC Symptom Assessment Scale (SAS) (172kb docx)
Symptom Assessment Scale (SAS)
If prescribing, ensure that medications are easily accessible and actually available in community pharmacies and are on the Pharmaceutical Benefits Scheme (PBS). Using the Palliative Care Schedule of the PBS and/or providing authority scripts allows core palliative care medications to be prescribed in larger quantities, and may cost the patient less.
If a problem does not respond to primary care management, or is complex, refer to specialist palliative care for further advice.
Access the PCOC SAS
View the RACGP Silver Book
View ELDAC's Common Clinical Tools
Last updated 24 August 2021