Step 2 - Assessment, care planning and review

An early assessment of an individual's needs and wishes as they approach the end of life is vital to establish their preferences and choices and identify any areas of unmet need.  It is important to explore the physical, psychological, social, spiritual, cultural and, where appropriate, environmental needs / wishes of each individual.

Tools to help include:

• Advance care planning, including the guide It all ADSE up (ask, document, share, evaluate)
• Preferred priorities for care
• Holistic common assessment
• Mental Capacity Act (2005)
• The AMBER care bundle
• e-ELCA e-learning modules on advance care planning and assessment - free for health and social care staff
• Support sheets, for example on advance care planning, advance decisions to refuse treatment, the Mental Capacity Act and holistic common assessment
• Capacity, care planning and advance care planning in life limiting illness
• Advance decisions to refuse treatment guide.
• Case studies relating to Step 2 of the care pathway