NICE Guideline > Assessment and care and support planning by an ME/CFS specialist team

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Assessment and care and support planning by an ME/CFS specialist team

1.5 Assessment and care and support planning by an ME/CFS specialist team

Also see the section on care for people with severe or very severe ME/CFS.

1.5.1 Carry out and record a holistic assessment to confirm the person's diagnosis of ME/CFS and inform their care and support plan. This should include:

  • a medical assessment (including relevant symptoms and history, comorbidities, overall physical and mental health, anything that is known to exacerbate or alleviate symptoms, and sleep quality)
  • physical functioning
  • the impact of symptoms on psychological, emotional and social wellbeing
  • current and past experiences of medicines (including tolerance and sensitivities), vitamins and mineral supplements
  • dietary assessment (including weight history before and after their diagnosis of ME/CFS, use of restrictive and alternative diets, and access to shopping and cooking).

1.5.2 Develop and agree a personalised care and support plan with the person with ME/CFS and their family or carers (as appropriate) informed by their holistic assessment. Include the following, depending on the person's needs:

  • information and support needs (see the section on information and support)
  • support for activities of daily living (see the section on access to care and support and recommendation 1.6.8 on accessing social care)
  • mobility and daily living aids and adaptations to increase or maintain independence (see the recommendations on aids and adaptations)
  • education, training or employment support needs (see the section on supporting people with ME/CFS in work, education and training)
  • self-management strategies, including energy management (see the recommendations on energy management)
  • physical functioning and mobility (see the recommendations on physical functioning and mobility)
  • managing ME/CFS and symptom management, including medicines management (see recommendations 1.12.1 to 1.12.26 on managing symptoms)
  • guidance on managing flare-ups and relapses (see the section on managing flare-ups in symptoms and relapses)
  • details of the health and social care professionals involved in the person's care, and who to contact (see recommendation 1.10.3).

1.5.3 Recognise that the person with ME/CFS is in charge of the aims of their care and support plan.

1.5.4 Give the person and their family or carers (as appropriate) a copy of their care and support plan and share a copy with their GP.

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