Key notes on symptom control issues in Palliative Care

Indications for treatment

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  All patients considered for treatment must have venous access and be willing to have IV therapy. It may be difficult to obtain informed consent, as the patient may be confused.
  
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  For treatment to be considered the patient must have a measured adjusted calcium of 2.8mmol/l, (normal range 1.8 –2.6mmol/l), and be symptomatic with a reasonable quality of life prior to the current deterioration, and not to have been treated for hypercalcaemia in the preceding six weeks.
  
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  If a patient does not want to be admitted to an institution, either hospice or acute medical ward, it may be inappropriate to investigate further as the management of hypercalcaemia involves iv rehydration followed by a bisphosphonate infusion, which may be difficult to supervise in the community.