Needs Assessment

A needs assessment supports personalised palliative care by identifying physical, emotional, social, and spiritual needs. Regular reassessments, especially after health changes or hospital stays, keep care up to date. Using validated tools helps you recognise needs early and guide referrals. By monitoring needs as part of your daily practice, you can improve care planning, support families, and enhance end-of-life care.

Read the supporting evidence

What I can do

A structured approach to needs assessment ensures that all aspects of a person’s care are considered. You can:

Incorporate validated tools like the Supportive and Palliative Care Indicators Tool (SPICT) (315kb pdf) or Integrated Palliative care Outcome Scale (IPOS) to assess symptoms, concerns and recognise deterioration
Consider physical, psychological, social, and spiritual needs, ensuring assessments are holistic
Use open-ended questions to explore a person’s values, preferences, and goals of care.

A person’s needs change over time, especially in palliative care. To reassess needs regularly:

Conduct reassessments during major health changes, after hospitalisation, or when requested by the person or their family
In residential aged care, participate in Needs Rounds — monthly meetings led by palliative care specialists to review and prioritise care for residents at risk of dying without a proper plan or symptom control
Document changes in care needs and communicate them to the broader care team.

What I can learn

Read the related palliAGED Improving Care pages:

Watch the ELDAC videos on assessing palliative care needs of older people in:

Read more on Assessment in palliative care for nurses on the CareSearch website.

What I can give

If an older person, their family or carer wishes to learn more about needs assessment, these resources may help:

SPICT-4ALL (371kb pdf) tool to help families and carers identify early signs of deterioration
Needs Assessment Tool for Carers (NAT-C) (342kb pdf) to help carers identify any concerns they may have
Carer Support Needs Assessment (CSNAT) to help carers explore their needs and what they feel would be helpful.

What I can suggest

Your team can enhance care coordination through structured needs assessments. Consider:

Implementing palliative care needs rounds in your residential aged care facility
Using protocols for reassessment during key transitions, such as post-hospital discharge or significant health deterioration
Having documentation and communication processes that allow individual older person needs to be shared across the care team.

To strengthen the role of needs assessment in care planning, your organisation might:

Conduct training sessions on needs assessment tools and how to apply them in practice
Have a standardised approach to assessing needs including preferred tools and explicit staff responsibilities
Encourage ongoing education on conducting sensitive conversations about care needs and end-of-life planning.

Page updated 10 April 2025