Palliative care help Welcome to your Palliative care help Is Palliative Care Right for You? It only takes a minute to answer five key questions that can determine whether palliative care could be right for you or someone close to you. 1. Have you experienced the following: Difficult side effects from treatment Eating problems due to a serious illness Frequent emergency room visits Three or more admissions to the hospital within 12 months, and with the same symptoms YesNo 2. Do you need help with: Knowing what to expect Knowing what programs and resources are available Making medical decisions about treatment choices/options Matching your goals and values to your medical care Understanding the pros and cons (benefits/burdens) of treatments (e.g dialysis, additional cancer treatments, surgery, etc.) YesNo 3. Do you have symptoms that make it difficult to be as active as you would like to be, or impact your quality of life? These symptoms might include: Pain or discomfort Shortness of breath Fatigue Anxiety Depression Lack of appetite Nausea Constipation YesNo 4. Do you need help with: Coping with the stress of a serious illness Emotional support Spiritual or religious support Talking with your family about your illness and what is important to you YesNo 5. Do you have one or more chronic illnesses such as: Cancer Congestive heart failure (CHF) Chronic obstructive pulmonary disease (COPD), emphysema, lung disease Kidney failure Liver failure YesNo Contact Names Email address Phone Number Time is Up!