Status message

The page you requested does not exist. A search for palliative performance scale resulted in this page.

Clinical Tools

Victoria Hospice offers the following useful clinical tools to help health care professionals in their assessment or treatment of patients facing advancing illness, death or bereavement. The Palliative Performance Scale and Bowel Performance Scale have been validated, while the others should be considered 'working forms.'

If you wish to print any of these tools for your use, please click here to download a copy of our reprint and use permission request form.

Bereavement Risk Assessment Tool [PDF]

The Bereavement Risk Assessment Tool, or BRAT, is a psychosocial assessment tool used by care team members to communicate personal, interpersonal and situational factors that may place a caregiver or family member at greater risk for a significantly negative bereavement experience. This information can be collected prior to the death of the patient and used to inform the care team of any immediate concerns regarding caregivers or family members, and may also facilitate the allocation of scarce bereavement services after the death.

This tool is shown as a sample only and is not be used without complete instructions and permission. For complete instructions and permission please purchase the Bereavement Risk Assessment Tool Manual with CD. See Publication Order Form for details.

Palliative Performance Scale

The Victoria Hospice Palliative Performance Scale (PPS, version 2) is an 11-point scale designed to measure patients' performance status in 10% decrements from 100% (healthy) to 0% (death) based on five observable parameters: ambulation, ability to do activities, self-care, food/fluid intake, and consciousness level.

English Version

Japanese Version

Thai Version

French Version

Portuguese Version

Dutch Version

Instruction and Information about PPSv2

Bowel Performance Scale [PDF]

Psychosocial Assessment Tool [PDF]

Respiratory Congestion Scale [PDF]

10 Steps to Better Prognostication [PDF]

Relationship Management [PDF]

Helpful information for health care providers when challenged by “difficult” patients.

Latest News

Thanks to the many hikers who showed up to walk, run, jog and even dance along the Westsong Walk on Sunday, May 6 at the first annual Hike for...
Swimathon 2012 logo
This year's event will run May 13th to 20th at nine participating recreation facilities around Greater Victoria. For more information, download the...
Mar. 14, 2012 – Adults and children deal with death and loss in different ways. Shaw TV's Sucheta Singh brings us the tragic story of how Karen Demeo...
The BC Ministry of Health recently released My Voice -- Expressing My Wishes for Future Care Treatment. This new advance care planning guide helps...

How to Register

Registration usually starts with a referral from your family physician. A Community Nurse from the Vancouver Island Health Authority (VIHA) will then follow up with a visit.