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Back to Module 3: Whole-Patient Assessment Nine Dimensions

Step 1. Illness/Treatment Summary
Step 2. Physical
Step 3. Psychological
Step 4. Decision-Making
Step 5. Communication & Information Sharing
Step 6. Social
Step 7. Spiritual
Step 8. Practical
Step 9. Anticipatory Planning for Death

Step 1. Illness/Treatment Summary

The patient seeking end-of-life care will likely have a long history with multiple interventions. A complete history should include:

• Primary diagnosis

• Illness's effects
• Treatment's adverse effects

• Secondary concurrent illnesses

• Treatment summary

Before moving beyond assessment to making a care plan for the patient:

• Consider whether previous treatments were appropriate based on:

• Their known effectiveness
• Patient preferences

• Verify that appropriate curative treatments have been considered

• If not, present these options to patient and proxy

• Consider that efforts to control the underlying disease may be appropriate even in advanced stages of illness

• Especially true with pediatric patients, whose parents may desire curative or life-prolonging therapy even in the face of poor prognosis

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