What to Expect at First Palliative Care Visit

After receiving a palliative care referral, a palliative registered nurse will call and explain what palliative care is to the patient and their designated healthcare agent. If the individual is agreeable to palliative services, an in-person consultation is scheduled.

At the first visit, the patient and their family will be visited by a social worker or a nurse practitioner. The palliative care specialist will provide disease education; discuss the individual’s healthcare goals; assess their physical, emotional and spiritual needs; and create a plan of care. This usually takes about 90 minutes; however, the consult may be shorter or longer. 

The purpose of the goals of care discussion is to determine what a person wants with regards to their healthcare in the future (advance directive) and what they desire right now (MOLST). The palliative specialist will help fill out or update the advance directive and/or MOLST based on the decisions made during the goals of care discussion.

After determining the person’s wishes, the specialist will then assess any physical, emotional or spiritual needs related to the chronic illness. If the social worker is visiting and finds there are emotional needs, he/she will provide a more in-depth assessment and create a plan based on the assessment. If he/she determines that there are physical symptom management needs, he/she will schedule a visit with the nurse practitioner. Similarly, if the nurse practitioner is at the first visit and determines the patient has emotional needs, he/she will schedule a visit with the social worker. If either the social worker or the nurse practitioner finds that the
person requires spiritual support, a request for chaplain support is made.