Sourcebook : 15.4 Suggestions for Quality Improvement : 15.4.3 Evaluate Suicidal End-of-Life Patients

Once risk factors are known, staff members need to know how to evaluate suicidal patients. Dr. William Breitbart (1993) recommends the following steps for such evaluation:

1. Establish rapport with an empathic approach.
2. Obtain patient’s understanding of illness and present symptoms.
3. Assess mental status.
4. Assess vulnerability variables and pain control.
5. Assess support system.
6. Obtain history of prior emotional problems or psychiatric disorders.
7. Obtain family history.
8. Record prior suicide threats, attempts.
9. Assess suicidal thinking, intent, plans.
10. Evaluate need for one-to-one nurse in hospital or companion at home.
11. Formulate treatment plan, immediate and long-term.

Adapted from W. Breitbart, Suicide risk and pain in cancer and AIDS patients, in C. R. Chapman & K. M. Foley (Eds.), Current and Emerging Issues in Cancer Pain: Research and Practice (pp. 49-65). New York: Raven Press.

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This online version of the book Improving Care for the End of Life: A Sourcebook for Health Care Managers and Clinicians is provided with permission of Americans for Better Care of the Dying [ www.abcd-caring.org ] and Oxford University Press. All rights reserved. For further information on quality improvement in end-of-life care visit The Palliative Care Policy Center [ www.medicaring.org ].