Assessment and re-assessment are critical in palliative care
Nurses often spend a lot of time caring for people with palliative care needs. Detecting changes in their condition can be more difficult when you regularly visit with a person. Systematic assessment helps to monitor for changes so that care measures can be implemented to prevent and relieve suffering as the end of life is approached.
In practice
Standardised approaches to clinical assessments provide a common language that can enhance communication with other health professionals and the people in your care.
Nurses can use certain assessment tools to assess:
- needs and deterioration
- symptoms
- function
- family and carer needs.
Related Resources
- CareSearch GP Hub – Assessing prognosis
- CareSearch GP Hub – Prescribing considerations in assessment
Some assessment tools cover a broad range of potential needs , for example:
- Supportive and Palliative Care Indicators Tool (SPICT) (571kb pdf)
- Supportive and Palliative Care Indicators Tool 4 All (SPICT-4ALL) (571kb pdf)
- Comprehensive Geriatric Assessment (CGA)
- Needs Assessment Tool for Carers (NAT-C) (342kb pdf)
- Carer Support Needs Assessment (CSNAT).
Other tools are more specific in their focus and support more in-depth assessments, for example, PAINAD (43kb pdf) or The Modified Borg Scale (mBORG) (181kb pdf).
Clinical assessment tools should be used appropriately and with caution, and not as a substitute for a comprehensive assessment.
Communication in assessment
Communication that is open, respectful, culturally safe, and comfortable enables effective conversations. This forms a key part of providing comprehensive care.
Nurses use communication skills to:
- actively listen and allow the person to express themselves; this may involve periods of silence
- understand the impact of any symptoms and what other factors influence these symptoms
- understand the person’s priorities and their preferences for care and place of care
- understand what information the person and their support network want to receive
- explore practical issues that might influence a person’s choices (e.g. cultural, spiritual, and geographical factors)
- check that they have a clear understanding.
For more information, see Communication.
Tools for overall assessment
The PEPSI COLA aide memoire for holistic patient assessment.
(This tool was developed in the UK therefore certain resources within it are specific to the UK.)
Barriers to assessment
Clinical assessment needs to be comprehensive, systematic, and ongoing; however, barriers to this often exist, such as lack of time, training and understanding of assessment.
It is worth remembering that people may downplay or not report symptoms because:
- of fears that worsening symptoms reflect disease progression and that treatment may stop
- they see it as an inevitable consequence of the disease, its treatment, or dying
- they may stop communicating about distress related to that specific complaint if they have been ignored before
- they do not want to worry their family
- they have been brought up to not complain, to be stoic.
Assessment in ongoing care resources
Last updated 22 May 2026