Deterioration is a decline in a person’s physical, cognitive, or functional health that signals the progression of a disease, the onset of an acute illness, or the transition to the last phase of life. Early identification allows nurses and careworkers to intervene promptly, manage symptoms proactively, and communicate effectively with the multidisciplinary team to support quality of life and avoid unnecessary or burdensome care.
What I can do
You can monitor for early signs of deterioration by:
- Being alert to changes in the physical, cognitive, or emotional health of those in your care
- Recognising subtle signs such as increased hospital visits, ongoing sleepiness, increased dependence on others, or changes in appetite or social engagement
- Using tools to assess and document concerns such as SPICT (315kb pdf) or Stop and Watch Early Warning Tool (341kb pdf).
Act on any concerns by:
- Assessing for any reversible causes such as sepsis, delirium, or dehydration
- Communicating any concerns promptly to the team or GP
- Anticipating care needs by introducing comfort measures and proactive symptom management.
Provide support and reassurance to families and carers by:
- Explaining what to expect as the older person’s condition changes
- Encouraging their involvement in advance care planning discussions, if appropriate
- Connecting people to available support services, such as Dementia Australia and grief and bereavement resources.
What I can learn
The palliAGED Practice Tips give helpful guidance on recognising deterioration in older people. There is a version for nurses as well as one for careworkers.
Complete the short palliAGED eLearning module on Person-Centred Care.
Enrol in the free Equip Aged Care Learning Modules which include a 10-minute introductory topic titled Person-Centred Care.
You can also:
Recognising deterioration in a resident
What I can give
If an older person, their family or carer is concerned about deterioration and what it might mean, these resources may help:
What I can suggest
Staff may benefit from training and education in recognising deterioration. Consider ongoing sessions that cover:
- Monitoring for signs of deterioration
- Communicating with families and carers about changes and what they might mean
- When and how to escalate concerns for prompt action.
Implement a structured approach to:
- Identifying deterioration through use of reputable assessment tools (e.g. SPICT, Stop and Watch)
- Communicating concerns amongst the team via ISBAR (Identify, Situation, Background, Assessment, Recommendation) at handovers or daily huddles to review residents at risk
- Engaging with palliative care teams for proactive, anticipatory symptom management and for discussing complex end-of-life care issues.
Page created 24 February 2025