When Prognosis Is Extremely Short: Approach to Depression Care in the Last Days to Weeks of Life

Clinically significant depressive symptoms are prevalent in advanced life-limiting illnesses. The assessment and management of such illness can be challenging for clinicians when prognoses are extremely short (days to weeks). Currently, evidence to guide practice is lacking, and there exists no guideline that specifically addresses depression care in this patient population. An approach, illustrated by the mnemonic "SCREENIN," is proposed in this commentary to optimize the care of individuals with depression when prognoses are extremely short. Even when prognosis is short, depression should still be routinely screened and promptly assessed, with proactive care delivered. There is an urgent need for clinician training, service linkage, research, and cultural change in this area through better collaboration between palliative care and psychiatry.