---
name: palliative-assessment
description: Use when asked to administer, score, or explain a Palliative Assessment — symptom-focused evaluation using the Edmonton Symptom Assessment System-revised (ESAS-r) — grounded in FormExamples/form-examples.
---

# Palliative Assessment

Symptom-focused palliative care assessment using the Edmonton Symptom
Assessment System-revised (ESAS-r) alongside performance status,
goals-of-care documentation, medication and symptom-control planning,
and psychosocial and spiritual review, to guide individualized
palliative management.

## Scoring

**Instrument:** ESAS-r — 10 symptoms each rated 0–10, total 0–100.

- **None (0–10)** — minimal symptom burden.
- **Mild (11–30)** — low burden; routine review.
- **Moderate (31–60)** — meaningful burden; escalate symptom control.
- **Severe (61–100)** — high burden; urgent review/hospice referral.
- **Individual flag:** any single symptom ≥ 7 triggers urgent
  single-symptom review regardless of the total.

## What it covers

Demographics; primary diagnosis and prognosis; ESAS-r symptom scoring;
performance status (PPS/KPS/ECOG); goals of care and advance care
planning documents; medications and symptom-control plan; psychosocial
and spiritual concerns; carer and family support; and a
multidisciplinary plan with referrals.

## Common pitfalls

- **Averaging away a single severe symptom in the total score** — the
  individual-symptom flag (≥ 7 on any item) exists precisely because a
  moderate total can hide one severely distressing symptom that needs
  urgent attention on its own.
- **Treating goals-of-care documentation as a one-time conversation** —
  goals of care evolve as disease progresses; the documentation should
  be revisited, not fixed at the first assessment.
- **Skipping spiritual and psychosocial review because the focus is
  physical symptoms** — these domains materially affect a patient's
  experience and are core, not supplementary, to palliative assessment.

## Learn more

- [FormExamples: palliative-assessment](https://github.com/FormExamples/form-examples/tree/main/forms/palliative-assessment) for the full implementation, clinical references, and worked examples.
- [[oncology-assessment]] for a related assessment relevant to advanced cancer.