Screening, assessment and referral to appropriate health professionals is required to meet the identified needs of the woman, her carer and family.

In addition to the common issues identified in the Appendix, specific issues that may arise at this time include:

• emotional and psychological distress from anticipatory grief, fear of death/dying, anxiety/ depression, interpersonal problems and anticipatory bereavement support for the woman as well as her carer and family
• practical, financial and emotional impacts on carers and family members resulting from the increased care needs of the woman
• legal issues including advance care planning, appointing a power of attorney or enduring guardian, completing a will and making an insurance, superannuation or social security claim on the basis of terminal illness or permanent disability
• arranging a funeral (provide information to the woman and her family)
• specific spiritual needs that may benefit from the involvement of pastoral care
• bereavement support for family and friends
• specific support for families where a parent is dying and will leave behind bereaved children or adolescents, creating special family needs
• physical symptoms including pain and fatigue
• change in physical appearance
• increasing dependence on others
• bowel obstruction or small bowel dysfunction (bowel issues such as constipation, diarrhoea and cramps may require support from a dietitian, continence nurse, stomal therapist or medical specialist)
• abdominal ascites (abdominal symptoms need monitoring and assessment)
• decline in mobility and/or functional status impacting on the woman’s discharge destination (a referral to physiotherapy and occupational therapy may be needed).