Holistic needs assessment

When your condition deteriorates and it looks like you are in the last weeks of life, this is the time to review what’s happening to you and assess your needs.  This is called a holistic needs assessment.  It may have been done before but it is useful to do it again now that your condition is changing to check that your needs are still being met.

Your carers should also have a holistic needs assessment.  They are on this emotional journey with you so it’s important to check that they have what they need to support them as they care for you.

This assessment is usually done by a health care professional who knows you.  If you have cancer, this person may be what’s called your ‘key worker’.  It may be your district nurse or a specialist palliative care nurse.  Whoever does the assessment, the idea is to check out what you need now and review plans for your future care.

The assessment is not just about practical issues and physical symptoms. It’s also about psychological and spiritual needs too so that as much can be done as possible to help you achieve the peaceful death you want in the place you choose.

The kind of things covered in a holistic needs assessment are:

• Are you where you want to be as the end of your life approaches?
• If not, how can we help get you there?
• • Example – you are in hospital but want to die at home
  • Example – you are at home and would like to die in a hospice
  • Unfortunately we can’t get you to that lovely beach you went to on holiday
• Review of your medication – do you still need medicines you may have been taking for years?
• What symptoms do you have now?
• What can be done to help control your symptoms?
• What symptoms may develop later?
• Organising a ‘just in case’ box of medication to have at home so it’s available at short notice if you need it
• Reviewing your wishes about burial or cremation, organ or tissue donation, funeral plans
• Who is looking after you? – are they managing? Do you need more help?
• Do you need to make changes at home? Example -   bringing your bed downstairs
• Do you want to go to church or be visited by your faith leader?
• Do you need help to deal with your emotions at this difficult time?
• Are you receiving all the financial help you are entitled to?
• Do you need to be referred to other professionals for more specialist help? For example – clinical psychologist, social worker, district nurse, specialist palliative care team, pain control team
• Are there treatments or procedures that you DON’T want?