Palliative care was created improve the quality of life of patients and their families, and to relieve serious health-related suffering that cannot be relieved without medical intervention, and when it compromises physical, social, or emotional functioning.

General referral criteria
Presence of a serious illness and one or more of the following:
• new diagnosis of life-limiting illness for symptom control, patient/family support
• declining ability to complete activities of daily living
• weight loss
• two or more hospitalizations for illness in three months
• difficult-to-control physical or emotional symptoms
• patient, family, or physician uncertainty regarding prognosis and/or treatment options
• conflicts or uncertainty regarding DNR orders, futile care, use of non-oral feeding/hydration
• limited social support in caring setting
• patient or family psychological or spiritual/existential distress

Cancer criteria
Presence of any of the above, and/or:
• failure of specific treatments
• Karnofsky < 50 or ECOG >3
• brain metastases, spinal cord compression, or neoplastic meningitis
• malignant hypercalcemia
• progressive pleural/peritoneal or pericardial effusions

Neurological criteria
Presence of any of the above, and/or:
• Folstein Mini Mental score <20
• status epilepticus >24 h
• ALS or other neuromuscular disease considering mechanical ventilation
• recurrent brain neoplasm
• Parkinson’s disease with poor functional status
• dementia with dependence in all activities of daily living

See reference for details.

Adapted from Palliative Care Referral Criteria. Updated April 15, 2022. Center to Advance Palliative Care (CAPC). Internet. Available at https://www.capc.org/documents/download/286/. Accessed on March 18, 2022.