The Palliative Care Outcomes Scale (POS) a patient self-report measure that assesses the physical symptoms and emotional, psychological and spiritual needs associated with serious illness. The POS can be used across clinical settings. 

Multiple versions have been developed (more information below), but for general clinical practice, the IPOS is recommended as the most streamlined version. The POS has a more robust evidence base, however, and is equally appropriate for general use.

Target Population: Clients with serious illness.

Time to Administer: 5-10 minutes

Key Features:

• 12 items. Likert scale. Translated into 12 languages (except POS-S).

• Valid and reliable (POS). Data still emerging for IPOS but is promising.

• Specific to the unique needs of persons living with serious illness.
  
  

Multiple versions of the POS have been developed. Use this summary to determine which is the right fit for your practice.

• POS (2 versions) - English & Translations

• Integrated POS (IPOS) - English & Translations

• African Palliative Care Association (APCA POS)

• POS-S (symptom list) - English & Translations

The Functional Assessment of Chronic Illness Therapy (FACIT) is a quality of life measure that addresses physical, social/family, emotional, and functional well-being. This measure is appropriate for seriously ill persons because it is brief and specific.

Multiple versions of the measure have been developed to target specific diseases, needs, age groups, treatments, and elements of care given/received. Use this library to find the measure most appropriate for your client. 

Target Population: Anyone with serious illness or caring for someone with serious illness.

Time to Administer: 10-15 minutes

Key Features:

• Brief. Likert scale. Many translations (some versions up to 80 languages).

• One of the few measures that targets pediatric clients as well as adults. 

• Level of reliability and validity is disclosed with each individual measure.

The Borg Rating of Perceived Exertion (RPE) Scale is a patient self-report tool that measures the intensity level of physical activity as experienced by the person. 

Understanding how hard patients are working to complete activities is a critical step to planning and appropriately grading activities for clients whose symptoms can fluctuate daily.

Target Population: Anyone for whom response to physical activity should be closely monitored.

Time to Administer: 1 minute or less

Key Features:

• Subjective measure that uses client's own schemas.

• Easy to use and understand.

  • • • Simply cue client during physical activity to describe how they feel using a number or phrase. Grade activities accordingly.

• Useful tool for developing clients' self-monitoring skills.

For more information on perceived exertion and the Borg RPE Scale, visit CDC.gov. 

The Modified Caregiver Strain Index (MSCI) is a caregiver self-report measure that assesses caregiver strain and stress related to five domains: financial, physical, psychological, social, and personal. 

Caregiving for seriously ill persons can put significant strain on the individual; addressing caregiving needs and setting goals for caregivers is well within the scope of OT (and an important role).

Target Population: Informal caregivers.

Time to Administer: 5 minutes

Key Features:

• 13 items. Easy-to-use Yes/No format. 

• Valid and reliable.

• Measures common areas of caregiver strain to personalize caregiver goals.

The STEADI Fall Risk Checklist assesses factors commonly associated with falls in older adults, including: fall history, medical conditions, medications, gait, strength, balance, vision, and postural hypertension. 

Symptoms of serious illness can fluctuate frequently, sometimes daily. When strength, gait, and balance become unpredictable, fall risk increases and should be addressed by OT.

Target Population: Healthcare providers assessing fall risk for older adults.

Time to Administer: 10 minutes

• Note. Checklist includes gait, strength, and balance assessments that may extend administration time if not previously administered.

Key Features:

• Easy-to-use Yes/No checklist with additional 'Notes' column.

• Does not assign numeric value to fall risk; purpose is to identify whether a risk is present or not.

• Serves as documentation that can be kept in clients' health records and used for client advocacy.

For additional resources and information related to the STEADI Initiative, visit CDC.gov/STEADI.

The Canadian Occupational Performance Measure (COPM) is a client self-reported outcome measure. The COPM is used with clients to "identify and prioritize everyday issues that restrict their participation in everyday living" (COPM, 2023). 

Target Population: Clients of all ages experiencing challenges with occupational performance.

• Most appropriate for clients who can actively participate in care planning.

• Appropriate for developing caregiver goals as well.

Time to Administer: 20-40 minutes

• Consideration: Many clients with serious illness experience fatigue, short bouts of wakefulness between long stretches of sleep, and/or distracting pain or discomfort. Assess your client to see if this longer, more in-depth measure is appropriate for them.

Key Features:

• Focuses on client's satisfaction in their occupational performance, not its quality. 

  • • Emphasis on meaningfulness and participation, not quantifiable improvement.

    • Uses client's own schemas and definitions to measure outcomes.

• Extremely collaborative. Client-directed. Available in 36 languages.

• Valid and reliable measure with over 500 articles published regarding its use.

Example case study of COPM in use in palliative care.

The Brief Fatigue Inventory (BFI) is a client self-report measure that assesses fatigue level and degree of fatigue impact on daily life and functioning.

Fatigue is a common symptom of serious illness and can have far-reaching impacts on daily life. OT can support clients in adapting their environments and activities to promote greater participation and fatigue management.

Target Population: Patients with cancer-related fatigue. 

• May be appropriate for other end-of-life care patient populations as well.

Time to Administer: 5 minutes

Key Features:

• 9 items on a 0-10 numeric rating scale.

• Easy to use with low demand on patient.

• Measures quality of life.

• Translated and validated in several languages.

**The free FACIT-F (Fatigue) or FACIT-Fatigue (Fatigue Scale) may be good, free alternatives if the BFI is unavailable to you.