Recognising Deterioration
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Tips for Careworkers:
Recognising Deterioration

What it is: Deterioration is when a person’s state of health declines (worsens). They may:

  • become bedbound (stay in bed)
  • spend more time sleeping or resting
  • have reduced intake of food (eat less)
  • have difficulty with swallowing, or
  • have fluctuating consciousness.

Why it matters: Recognising that a person is deteriorating is important so that:

  • this can be discussed with the person and their family
  • care is reviewed with the person (if able), the family and GP
  • a palliative care plan or pathway can be started or changed
  • care is given in line with the person’s wishes
  • symptoms are managed appropriately
  • support to the person, the family and staff can be provided.

Careworkers often care for people on a daily basis and may notice signs of deterioration.

What I need to know: Many people suffer from chronic (long-term) conditions that are not always recognised as life-limiting (e.g., dementia).

The terminal or end phase of care for conditions like dementia and organ failure can extend over months or years. Signs of deterioration should be reported to nursing/supervisory staff.

Do

Look out for and report to the nursing/​supervisory staff if:

  • a person has changes in level of usual activity or engagement including a reluctance to get out of bed
  • a person needs help from others for care due to increasing physical or mental health concerns
  • a person loses weight or stays underweight
  • a person has poor general health that is getting worse or not improving
  • symptoms persist despite appropriate management
  • there are emergency transfers to hospital
  • the carer increasingly needs help and support.
 

Do

Ask nursing/supervisory staff about SPICT4ALL (299kb pdf), a tool to identify when a person’s health is declining.

 

Do

Ask nursing/supervisory staff to show you the forms used to help determine deterioration.

 

My reflections:

 

What tool can be used to tell if someone’s health is deteriorating?

 

What changes should I report to nursing/supervisory staff?

See related palliAGED Practice Tip Sheets:

Case Conferences

End-of-Life Care Pathways

Frailty

 

For references and the latest version of all the Tip Sheets visit www.palliaged.com.au/PracticeTipSheets

 

CareSearch is funded by the Australian Government Department of Health and Aged Care.
Updated July 2022

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