Background Previous work by the author and, in collaboration with the Food and Nutrition Group at Hospice UK and the Department of Nutrition at the University of Surrey, highlighted the need for a specialist nutrition tool in palliative care. Nutrition can be influenced by disease and treatment-related factors as well as emotional, social and cultural factors. In addition, food allergies/intolerances and preferences should be taken into account when offering food or dietary advice. Last but not least, weight and nutritional changes can be a useful adjunct to the prognostic algorithm.

Aim The PLANT tool has been designed to explore a number of symptoms that can affect the nutritional status of palliative patients.

Methods The prototype PLANT was designed and developed in the last two years with the feedback of patients, doctors, nurses and dietitians. It has two parts: a patient questionnaire and a clinical assessment. It has been used in different settings.

Results PLANT is a practical tool that can be used in the hospice, community and outpatient settings. It can:

• identify potentially reversible causes (such as pain, nausea, constipation etc) which can influence the patient’s food intake and nutritional status

• highlight specific food and nutritional needs that can be translated into care plans

• facilitate communication between multidisciplinary team members

• assist healthcare professionals in estimating survival of patient.

Conclusions Nutritional and wellbeing status should be assessed, except if patients are within the last days of life (‘dying’ phase of illness). The PLANT tool, by taking into account aspects of life-state and food and nutrition, supports healthcare professionals in their history-taking and decision-making, to provide better care. There are a number of challenges for its use, such as changing practice, introducing yet another tool but, most importantly providing education and training on nutritional and lifestyle care.