Development of PAL MIND: a palliative care clinical tool to inform a pilot study

TL;DR

This paper introduces PAL MIND, a new clinical tool for palliative care that helps identify psychological needs and improve treatment for older adults with chronic diseases.

Contribution

The novel contribution is the development of PAL MIND, a comprehensive palliative care tool tailored for older adults with chronic multimorbidity.

Findings

PAL MIND combines intake and assessment screeners to identify psychological needs in inpatient palliative care.

The tool is designed to improve interdisciplinary understanding and facilitate targeted treatment interventions.

A pilot test will assess the feasibility of using PAL MIND in an ICU setting.

Abstract

As the adult population ages, chronic multimorbidity is estimated to increase by over 90%, leading to decreased quality of life. Palliative care supports chronic disease management and increases quality of life. Newer subspecialties of palliative care (e.g., neuro-palliative care and geri-palliative care) holistically address disease management and provide interventions to older adults with chronic multimorbidity and cognitive concerns to address their unique health needs in an inpatient setting. This study describes the development of PAL MIND, a clinical tool that uses a combination of intake and assessment screeners to comprehensively identify patients’ psychological needs during their inpatient stay as well as inform outpatient treatment next steps; additionally, the tool grows interdisciplinary understanding of psychological services available to patients. PAL MIND was developed based on a literature review of measures validated in palliative and geriatric patient samples. Intake sections include: patient demographics, biopsychosocial spiritual evaluation, risk evaluation, mental status exam, functional evaluation, and treatment communication evaluation. Assessment sections include: orientation screener, cognitive screener, mental health screener, palliative care screener, and advanced care planning screener. Next, we will pilot-test the tool in a regional inpatient hospital setting to determine the feasibility of tool delivery in an ICU setting. The tool has the potential to identify patient needs regarding psychological services and treatment preferences, which can facilitate interdisciplinary care and targeted treatment interventions for older adults with chronic and terminal diseases in inpatient settings.