Promoting Excellence : Advanced Illness Management- Transition Questions

Instrument Name:
Sutter VNA & Hospice:  Advanced Illness Management- Transition Questions
A list of topics to be covered and questions to ask by the care provider of a patient transitioning into hospice care. 

Clinical Care Tools – Advance Care Planning

Sutter VNA and Hospice
1900 Powell St, Suite 300
Emeryville CA 94608

Brad Stuart M.D.
[email protected]

How the grantee used this instrument: 
This list of questions was used by care providers in conjunction with the Advanced Health Care Directives Form, and the Advanced Directive Intervention List in helping the patient understand the illness and plan for the future. 
advance care plan, advance directives, decision-making, preferences, care plan

To use this tool: 
You may print and copy this tool for your own use from this site.  Please credit source.

Developed specifically for this project by the project team.

To view this tool:
To view the tool in your browser left-click on the link below or to download to your computer right-click on the link.
pdf PDF 52 KB / 1 page


Sutter VNA and Hospice overview page

Promoting Excellence in End-of-Life Care was a national program of the Robert Wood Johnson Foundation dedicated to long-term changes in health care institutions to substantially improve care for dying people and their families. Visit for more resources.

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