• Assess the person's physical support needs at key points during the course of the illness (e.g. at the time of diagnosis, around treatment episodes, as treatments end, at the time of a relapse, and when death is approaching).
• Assess and manage the person systematically (e.g. assess symptoms, set treatment goals, review regularly, and refer if necessary).

In depth

• Assess the person's psychological state at key points during the course of the illness (e.g. at the time of diagnosis, around treatment episodes, as treatments end, at the time of a relapse, and when death is approaching).
• Offer general emotional support including skilled communication, effective information provision, courtesy, and respect.
• If the person or their carers have significant levels of psychological distress, prompt referral to specialist psychological care services should be offered.
• The appropriate psychological intervention will depend on the person's current and previous psychological problems, the level of support available, and their prognosis.

In depth

• Assess the person's social needs at key points during the course of the illness (e.g. at the time of diagnosis, around treatment episodes, as treatments end, at the time of a relapse, and when death is approaching).
• Social care and support needs include: help with personal care (e.g. bathing and dressing), housework and shopping, practical aids (e.g. wheelchairs), caring for dependents (e.g. children or elderly relatives); and advice on work, employment issues, and benefit claims.

In depth

• Assess the person's spiritual needs (a person's search for meaning within his or her life) at key points during the course of the illness (e.g. at the time of diagnosis, around treatment episodes, as treatments end, at the time of a relapse, and when death is approaching).
• Spiritual and existential (concerned with human existence and the meaning of life) support for people who are receiving treatment or are at the end of life includes: listening to the person and discussing their questions; affirming their humanity; protecting their self worth, dignity, and identity; and ensuring that spiritual care is offered along with psychological, social, and emotional care as part of a holistic approach.

In depth

• Offer family members and carers the opportunity for their needs (e.g. for support and information) to be assessed separately from those of the patient.
• Whenever possible and appropriate, invite family members and carers to be involved during clinical encounters and decisions about treatment and care (if this reflects the wishes of the person receiving palliative care).
• Family members and carers should be made aware of local sources of information, advice, and support, to address their own needs.
• Particularly address the needs of the family and/or carers at demanding times in the person's illness and when extra help may be needed.
• Consider that people of different ethnic backgrounds or cultures may have specific preferences regarding family involvement.
• The family can be helped by:
• Facilitating communication between the person and their family and health care professionals.
• Recognizing areas of stress in other areas (e.g. work, coping with children).
• Education to provide the skills and knowledge to provide the necessary aspects of care to enhance the person's comfort.
• Discussion of pain management to reduce anxiety regarding potential addiction or tolerance.
• Encouraging expression of fears, concerns, uncertainty, and emotional strain.
• Provision of information regarding the person's death and what to expect.

In depth