0504 FAMCARE Online Forms Current User: Not Logged In
Completion Errors
Your Experience of Palliative Care and End of Life Care across Torbay and South Devon NHS Foundation Trust
Location:
Acute Hospital
Community Hospital
Home
Other
Completed by:
Family Member
Friend
Other
Patient Name or
Hospital Number (Optional):
In Which Ward/Place Did Your
Relative or Friend Die?
Name of Person Completing
the Form (Optional):
 How satisfied were you with:
The patient's comfort?
The way in which the team
respected the patient's dignity?
The patient feeling safe
within the clinical/home area?
Family/friends feeling safe
within the clinical/home area?
The way in which the patient's
physical needs for
comfort were met?
The practical personal assistance
provided to the patient by the team
with personal care?
Discussions with the team
about the patient's condition and
plan of care?
The way family/friends were
included in treatment and care
decisions?
The team's attention
to the patient's symptoms?
The way the team managed
the patient's symptoms?
The team's response to
changes in the patient's care needs?
Emotional support provided to the
patient by the team?
Emotional support provided to
family members/friends
by the team?
Very
Satisfied
Satisfied
Neither Satisfied
nor
Dissatisfied
Dissatisfied
Very
Dissatisfied
Not Relevant
to my
Situation