For Referring Physicians
Palliative Care Program
Additional Information for Physicians
Consult requests can be initiated directly in the computer or by contacting the Palliative Care team. Beeper (732) 437-3670 or Extension 5717.
Palliative care is a medical specialty that supports the primary care physician's care of patients with serious and life-threatening illness. Palliative care is not in place of curative care.
Why the need for palliative care now?
Palliative care is in greater demand because it addresses stronger emphasis on quality of care and the stresses placed on the medical system from the growing aging population.
How can palliative care help the attending physician?
Physicians with seriously ill patients who require complex pain and symptom management or have a high demand for patient/family communication can refer to palliative care specialists. Palliative care programs offer attending physicians:
- Satisfied patients
What patients are suitable for a palliative care consult?
General Referral Criteria (one or more of the following):
- Frequent hospitalizations for same diagnosis
- Difficult to control physical or emotional symptoms related to serious medical illness
- Uncertainty regarding prognosis, goals of care
- Patient or family requests for futile care or physician request for information regarding hospice appropriateness
- DNR order conflicts
- Limited social support and a serious illness (e.g. homeless, chronic mental illness)
Intensive Care Unit Referral Criteria
- Admission from a nursing home in the setting of one or more chronic life-limiting conditions (e.g. dementia)
- Two or more ICU admissions within the same hospitalization
- Prolonged or difficult ventilator withdrawal
- Multi-organ failure
- Consideration of ventilator withdrawal with expected death
- Metastatic cancer
- Anoxic encephalopathy
- Family distress impairing surrogate decision-making
Oncology Referral Criteria
- Metastatic or locally advanced cancer progressing despite systemic treatments and functional decline
- Karnofsky < 50 or ECOG > 3
- Failure of appropriate/salvage chemotherapy
- Uncontrolled pain
Emergency Department Referral Criteria
- Multiple recent prior hospitalization with same symptoms/problems
- Long-term care patient with Do Not Resuscitate (DNR) and/or Comfort Care (CC) orders
- Consideration of ICU admission and or mechanical ventilation in a patient
- with metastatic cancer and declining function
- with moderate to severe dementia
- with one or more chronic diseases and poor functional status at baseline
Consult Requests can be initiated directly in the computer or by contacting the Palliative Care team. Beeper (732) 437-3670 or Extension 5717.