See validated screening tools mentioned in Principle 4 ‘Supportive care’.

A number of specific challenges and needs may arise for patients at this time:

• assistance for dealing with emotional and psychological distress from anticipatory grief, fear of death or dying, anxiety/depression and interpersonal problems
• management of physical symptoms
• decline in mobility or functional status, affecting the patient’s discharge destination (a referral to physiotherapy, exercise physiology, occupational therapy or social work may be needed)
• appointing a substitute decision-maker and completing an advance care directive
• legal issues (completing a will, care of dependent children) and making an insurance, superannuation or social security claim on the basis of terminal illness or permanent disability specific support for families where a parent is dying and will leave behind bereaved children or adolescents, creating special family needs
• arranging a

These services and resources can help with:

• referral to the Cancer Council Australia’s Pro Bono Program (13 11 20) for free legal, financial, small business accounting and workplace assistance (subject to a means test)
• Sad news sorry business (Queensland Health 2015) for the specific needs of Aboriginal and Torres Strait Islander people
• referral to Redkite (1800 733 548) for financial assistance during palliative care, with funerals and in the first year of bereavement, as well as counselling and social work services during end-of-life care and bereavement support and counselling
• referral to Canteen (1800 226 833) for similar supports (not financial assistance)
• referral to the Leukaemia Foundation (1800 620 420) for emotional, physical and psychosocial support for the challenges of a cancer diagnosis, treatment and

For more information on supportive care and needs that may arise for different population groups, see Appendices A, B and C.

The lead clinician is responsible for:

• being open to and encouraging discussion with the patient, carer and family about the expected disease course, considering the patient’s personal and cultural beliefs and expectations
• discussing palliative care options, including inpatient and community-based services as well as dying at home and subsequent arrangements
• providing the patient and carer with the contact details of a palliative care service
• referring the patient to palliative care in the community according to the carer’s wishes
• referring the carers and family to bereavement support from community support