Early identification of palliative patients
The General Medical Council define ‘people approaching end of life’ as those who are likely to die within the next 12 months which might include those with advanced, progressive and incurable conditions, those who are frail with co-morbidities and those at risk of dying from a sudden acute crisis.
There are general indicators that might allude to people who are becoming more unwell. These are:
· Poor performance status (limited self care or in a chair or bed at least 50% of the day)
· Progressive weight loss (>10%) over 6 months
· 2 or more hospital admissions within 6 months
· Nursing home patient or one requiring increasing care at home
The clinical frailty scale also allows identification and stratification of people who are becoming frail and this has been shown to correlate directly with mortality rates. The score is easily identified through matching people to a set of pictures and gives another tool to assess elderly people through a quick observation within a clinical encounter.