Table 1 The RADboud indicators of PAlliative Care needs (RADPAC)

1. The patient has severe limitations, experiences symptoms even while at rest. Mostly bedbound patients. (NYHA IV)

2. There were frequent hospital admissions (> 3 per year)

3. The patient has frequent exacerbations of severe heart failure (> 3 per year)

4. The patient is moderately disabled; dependent. Requires considerable assistance and frequent care

(Karnofsky-score ≤ 50%)

5. The patient increases in weight what is not responding to increased dose of diuretics

6. A general deterioration of the clinical situation (oedema, orthopnoe, nycturie, dyspnoea)

7. The patient mentions 'end of life approaching'

1. The patient is moderately disabled; dependent. Requires considerable assistance and frequent care

(Karnofsky-score ≤ 50%)

2. The patient has substantial weight loss (± 10% loss of bodyweight in six months)

3. The presence of congestive heart failure

4. The patient has orthopnoe

5. The patient mentions 'end of life approaching'

6. There are objective signs of serious dyspnoea (decreased dyspnoea d' effort, dyspnoea with speaking, use of respiratory assistant muscles and orthopnoe)

1. Patient has a primary tumour with a poor prognosis

2. Patient is moderately disabled; dependent. Requires considerable assistance and frequent care

(Karnofsky-score ≤ 50%)

3. There is a progressive decline in physical functioning

4. The patient is progressively bedridden

5. The patient has a diminished food intake

6. The presence of progressive weight loss

7. The presence of the anorexie-cachexie syndrome

(lack of appetite, general weakness, emaciating, muscular atrophy)

8. The patient has a diminished 'drive to live'