Promoting Excellence : Palliative Care Screen

University of Pennsylvania School of Nursing/Genesis Eldercare: Palliative Care Screen

A one-page assessment sheet to identify potential palliative care needs in patients newly admitted to nursing homes.

Organizational Tool — Enrollment Criteria/Patient Identification

University of Pennsylvania
School of Nursing
Hartford Center of Geriatrics
420 Guardian Drive
Philadelphia, PA 19104-6096

Neville Strumpf, PhD,RN
[email protected]

How the grantee used this instrument:
Used to identify very far advanced or end stage illnesses and goals of the family and patient consistent with what the ElderCare program offered.

nursing homes, symptom assessment, care planning

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

Developed by the University of Pennsylvania School of Nursing and the Genesis Palliative Care Center for this project.

To view this tool:
Left click on the download link to view the PDF document in your Web browser. Right-click on the download link to save the document to your computer.
pdf PDF 39 KB / 1 page (Viewing PDF files requires downloading and installation of the free Adobe Acrobat Reader.)

Posted October 2004

University of Pennsylvania overview page

# UP05, type:enrollment_criteria

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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