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Palliative cancer care - oral problems - Management
What assessment do I need to make?
- Perform a full history and examination. Assess concurrent symptoms, psychological state, social needs, and spiritual needs. See the CKS topic on Palliative cancer care - general issues.
- Assess the person's:
- Understanding of the diagnosis and their current problems.
- Coping ability, and how their family/carer is coping.
- Nutritional status and whether their fluid intake is adequate.
- Level of oral hygiene and whether they can carry out routine oral care.
- Estimate the likely prognosis, if possible. For further information, see Prognostic Indicator Guidance (pdf), which is part of the Gold Standards Framework.
Clarification / Additional information
Basis for recommendation
- These recommendations are based on national guidance from the National Institute for Health and Clinical Excellence (NICE) and expert opinion [NICE, 2004; Regnard and Hockley, 2004].
- As symptoms are often multiple and interrelated, a systematic approach to assessment and management is necessary.
- Assessment and discussion of the person's needs for physical, psychological, social, spiritual, and financial support should be undertaken at key points (such as at diagnosis; at commencement of, during, and at the end of treatment; at relapse; and when death is approaching).
- Terminal illness may affect the relationship between the person and their family. It is important to recognize this and to offer appropriate support and advice when needed.
- Always carry out assessments and make decisions in partnership with the person and their carers.
[NICE, 2004]
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