It is recommended that a needs assessment be conducted at diagnosis of a life-limiting condition, at times of significant change (significant decline or deterioration, or change in family/social support or in functional status), after a hospital admission, at the request of the family or at the beginning of the terminal phase.  Needs assessment tools developed to assess palliative care have been mostly developed and tested for oncology patients with fewer tools for other patient groups. 
In a research setting, needs assessment tools can also be used to develop targeted interventions and reliable outcome measures to assess the effectiveness of interventions. [2,4-6] Needs assessment tools can also be used to identify unmet health and healthcare needs of a population and determine what should be done, what can be done, and what is affordable. [12,13]
The needs assessment tools used in a palliative care setting include the:
These are not specific to older adults. The IPOS-Dem can be used for the regular assessment of aged care residents with dementia. The few needs assessment tools specific to the needs of older people are comprehensive geriatric assessments (CGAs) or specific to heart failure, chronic obstructive pulmonary disease (COPD) or carers of people with dementia. [2-11]
A comprehensive geriatric assessment (CGA) can be used to plan appropriate and coordinated care relevant to identified needs of older people who are frail or who have complex needs. [2,11] The five main domains assessed in a CGA are physical health, mental health, functional ability, social functioning and environmental context.  A CGA is commonly used to assist frail older people hospitalised with an acute illness  as this is where they are most likely to be assessed and where they will be at a critical phase in their care.  The EASY-care tool is a comprehensive geriatric assessment (CGA) designed for assessing the unmet health and social needs of older people living in the community. 
The Needs Assessment for Progressive Disease-Heart Failure (NAT: PD-HF) (Figure 2, 3 and 4) assesses a range of needs for both heart failure (HF) patients and their carers. [2,9,10] It can be used in generalist as well as specialist palliative care settings.  Including the NAT: PD-HF in an annual heart failure review can facilitate the integration of palliative care for HF patients and improve overall quality of life at a more functional stage in the disease.  Combining the NAT: PD-HF and SPICT allows for a variety of triggers to flag the need for re-negotiating goals of care.  Other tools not specific to heart failure can be used in the care of people with chronic heart failure as they include indicators of
Several tools can be used to assess and address the needs of people living with chronic obstructive pulmonary disease (COPD). These include the Clinical COPD questionnaire (CCQ), the COPD Assessment Tool (CAT) and the Support Needs Approach for Patients (SNAP).
The IPOS-Dem is a tool used to assess how certain symptoms and problems have affected a resident with dementia over the previous week.  The tool assesses physical, functional, psychosocial, and practical aspects of the person’s life. Two questions consider the experience of the family. The Carers’ Needs Assessment for Dementia (CNA-D), Partnering for Better Health – Living with Chronic Illness: Dementia (PBH-LCI:D) and the Questionnaire consultation expectations (EAC) have been developed to assess the needs of carers of people living with dementia. [4-6] For more information visit the palliAGED Cognitive Impairment and Dementia evidence summary and the CareSearch Clinical Evidence topic Advanced Dementia.
The quality of the included papers is acceptable to high quality.
Page updated 13 October 2022