The SENS structure was created on the basis of the thematic evaluation of 500 consultation reports of the palliative consultancy service at the Cantonal Hospital St. Gallen as part of the development of quality standards for “Palliative Care”. The aim was to find a common thematic structure for patients, relatives and clinicians, and thus an equally guiding and meaningful representation of the main questions in advanced diseases. These topics help create a common language and take the focus away from medical and nursing terminologies. Problems and worries are addressed, as well as individual resources and “sources of energy”, in order to cope with the challenges of advanced disease and the last phase of life.