NCCN criteria for palliative care assessment

Patient characteristics	Social circumstances or issues related to anticipatory bereavement
Limited options for treatment	Limited access to care
High risk of poor pain control or refractory pain. Risk factors include: Neuropathic pain Incident or breakthrough pain Rapid escalation of opioid dose History of substance (drug, alcohol) abuse Impaired cognition Psychosocial/family distress	Familial factors, including: Limitations of the family/caregiver Inadequate family support Family discord History of intensely dependent relationship(s) Parental concerns regarding care of dependents
High symptom burden or distress score	Financial limitations
Intensive care unit admission with multiple complications or need for prolonged ventilator support	Unresolved grief or multiple prior losses
Physical symptoms other than pain that are refractory to conventional management	Spiritual or existential crisis
Cognitive impairment
Severe or multiple comorbid conditions
Communication barriers related to language, literacy, or physical issues
Request for hastened death
Inability to engage in advance care planning and care plan

Source: NCCN Guidelines Version 2.2012. Palliative Care.

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