Palliative and End of Life Care Notes

Palliative Care

• Palliative care aims to enhance the quality of life for individuals diagnosed with chronic, life-limiting conditions. This care extends from the point of diagnosis through the end of life, including bereavement support for the family and care of the body post-mortem.

Palliative Performance Scale (PPS)

• The Palliative Performance Scale (PPS) is a tool used by healthcare professionals to assess a patient's functional status during serious illness.
• It evaluates five key areas:
  • Ambulation
  • Activity level and evidence of disease
  • Self-care abilities
  • Food and fluid intake
  • Level of consciousness
• Scoring ranges from 0% (non-functional) to 100% (fully active), guiding care decisions such as hospice eligibility and palliative care needs.

PPS Levels

• 100%: Full activity and work capacity; no evidence of disease.
• 90%: Full activity and work with some evidence of disease.
• 80%: Normal activity with effort; some evidence of disease; may have reduced activity levels.
• 70%: Reduced activity; unable to maintain normal job or work; significant disease; may require occasional assistance.
• 60%: Reduced activity; unable to do normal hobby or housework; significant disease; may require occasional assistance; may exhibit confusion.
• 50%: Mainly sitting or lying; unable to do any work; extensive disease; may require mainly assistance; may exhibit confusion.
• 40%: Mainly in bed; unable to do most activities; extensive disease; requires extensive assistance; may exhibit drowsiness or confusion.
• 30%: Totally bed bound; unable to do any activity; extensive disease; requires total care; may exhibit drowsiness or confusion.
• 20%: Totally bed bound; unable to do any activity; extensive disease; requires total care; minimal intake to sips; may exhibit drowsiness or confusion.
• 10%: Totally bed bound; unable to do any activity; extensive disease; requires total care; mouth care only; may exhibit drowsiness or coma with confusion.
• 0%: Death

Defining a