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PATIENT REFERRAL FORM FOR SPECIALIST PALLIATIVE CARE Private & Confidential Referral Criteria Patient has progressive, life limiting diagnosis has complex problems that cannot be adequately addressed.

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What is end of life care? Stage 1: Creating a plan. Stage 2: Preparing emotionally. Stage 3: Early stage care. Stage four: Late stage care. Stage five: Supporting your loved ones.

Palliative care is a resource for anyone living with a serious illness, such as heart failure, chronic obstructive pulmonary disease , cancer, dementia, Parkinson's disease, and many others. Palliative care can be helpful at any stage of illness and is best provided soon after a person is diagnosed.

Specialist palliative care services manage complex palliative care problems that cannot be dealt with by generalist services. Ideally, professionals who are not specialists in palliative care, who care for people with advanced cancer, should have access to specialist advice at all times.

Palliative Care vs Hospice Care Hospice is comfort care without curative intent; the patient no longer has curative options or has chosen not to pursue treatment because the side effects outweigh the benefits. Palliative care is comfort care with or without curative intent.

Referral criteria The patient will have a progressive illness, with supportive and palliative care needs. The patient will be 14 years or older. Referrals will be based on the needs of the patient and his or her family rather than the diagnosis. The patient has consented to the referral.

This type of care can include: Medication to relieve symptoms and side effects. Other treatments, such as radiation therapy or surgery, to relieve symptoms and side effects. Physical therapy and rehabilitation. Nutritional changes. Spiritual and emotional support, including counseling and relaxation techniques.

The goals of palliative care to maximise the quality of life. to provide relief from pain and other physical symptoms. to provide psychosocial and spiritual care. to provide support to help the family during the patient's illness and in their subsequent bereavement.

This type of care can include: Medication to relieve symptoms and side effects. Other treatments, such as radiation therapy or surgery, to relieve symptoms and side effects. Physical therapy and rehabilitation. Nutritional changes. Spiritual and emotional support, including counseling and relaxation techniques.

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Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
DMCA Policy
About Us
Blog
Affiliates
Contact Us
Privacy Notice
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate workflows
DocHub
Instapage
Social Media
Call us now toll free:
1-877-389-0141
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232