PALLIATIVE CARE PARTNERSHIP Community Palliative Care Team REFERRAL FORM Hospice Home Team The Martlets Hospice Wayfield Avenue HOVE BN3 7LW In order to assist us to process this referral appropriately,.
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How to fill out the Palliative Care Form online
Filling out the Palliative Care Form online can streamline the referral process for palliative care services. This guide aims to provide clear instructions to ensure that you complete the form accurately and efficiently, promoting effective patient support.
Follow the steps to successfully fill out the Palliative Care Form.
- Click 'Get Form' button to obtain the form and open it in your browser.
- Begin by entering the patient details, including their surname, first name, date of birth, and age. Make sure to confirm the patient’s consent for referral and whether the GP is aware of it.
- Provide the patient's address and contact details, including telephone and mobile numbers, as well as the NHS number and hospital number if applicable.
- Complete the section regarding the patient's primary diagnosis and any relevant history of disease and treatment, ensuring you use the guidance provided by the GSF Prognostic Indicators.
- Fill in the Next of Kin or Patient Representatives section, including their contact information and relationship to the patient.
- Indicate whether a Do Not Attempt Cardio-Pulmonary Resuscitation (DNACPR) is in place and if the community nursing team has been contacted.
- Detail the reason for referral, selecting any applicable options related to complex pain, symptom control, social, psychological, or spiritual needs.
- Specify the service requested, whether it be an assessment at home, in a hospital, or at a nursing home.
- Answer questions regarding the patient's living situation, mobility, current medications, and any known drug sensitivities or allergies.
- Complete the sections regarding the patient's awareness of their diagnosis and prognosis, as well as the awareness of the carer.
- Finally, fill out the referrer’s name, signature, job title, contact number, and the date before saving your changes.
- After completing the form, you can download, print, or share it as needed.
Complete your Palliative Care Form online today for efficient processing of care referrals.
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Does palliative care mean your dying?
The purpose of palliative care is to address symptoms such as pain, breathing difficulties, or nausea, among others. Receiving palliative care does not necessarily mean you're dying. Palliative care gives you a chance to live your life more comfortably.
What is included in palliative care?
End of life and palliative care aims to help you if you have a life-limiting or life-threatening illness. The focus of this type of care is managing symptoms and providing comfort and assistance. This includes help with emotional and mental health, spiritual and social needs.
When should someone be offered palliative care?
You may start palliative care at any stage of your illness, even as soon as you receive a diagnosis and begin treatment. You don't have to wait until your disease has reached an advanced stage or when you're in the final months of life. In fact, the earlier you start palliative care, the better.
Why palliative care is bad?
Palliative care has a bad rap and is often underutilized because of the lack of understanding of what it is. Patients panic when they hear palliative care and think it means they are dying. But palliative isn't only for people who are terminally ill, and it is not the same as hospice care.
How long can you be in palliative care?
FACT: You can receive palliative care at any point in your illness. Some people receive palliative care for years, while others will receive care in their last weeks or days.
What happens when palliative care starts?
What is palliative care? End of life care includes palliative care. If you have an illness that cannot be cured, palliative care makes you as comfortable as possible, by managing your pain and other distressing symptoms. It also involves psychological, social and spiritual support for you and your family or carers.
Is palliative care end of life care?
End of life care includes palliative care. If you have an illness that cannot be cured, palliative care makes you as comfortable as possible, by managing your pain and other distressing symptoms. It also involves psychological, social and spiritual support for you and your family or carers.
At what stage does palliative care start?
You may start palliative care at any stage of your illness, even as soon as you receive a diagnosis and begin treatment. You don't have to wait until your disease has reached an advanced stage or when you're in the final months of life. In fact, the earlier you start palliative care, the better.
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