Recognise end of life
To provide high quality end of life care, we need to be able to identify those who could benefit from this care. Recognising that a person is at the end of their life gives us time to identify and respond to their needs.
This can include support from other healthcare teams. Routine use of simple trigger tools and questions can help aged care staff consider whether a person might be in the last months of life.
How to recognise end of life
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Simple screening checks
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The Surprise Question
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The SPICTTM
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Why it's important
- The Surprise Question and SPICTTM are commonly used trigger tools for more detailed assessment.
- Continued deterioration despite interventions could prompt review.
- Multiple recent hospital admissions can be an alert to consider end of life.
You can ask the surprise question for older people in your care:
- “Would you be surprised if this person died in the next 12 months?”
- “Would you be surprised if this person died in the next days or weeks?
If the answer is no, they may be approaching the end of life.
The SPICTTM (188b pdf) is often used on top of the surprise question. It can help you find out if people have serious health problems that are getting worse.
You can then review and plan for their care.
The SPICT-4ALLTM (190kb pdf) is another version which has simpler language and is designed for everyone to use.
If someone is “SPICTTM positive”, they will have:
- At least two general indicators AND
- One serious health condition.
This means that they may need end of life care as they could be at risk of dying within 12 months.
- Recognising that a person can benefit from end of life care is the first step to providing timely and quality care.
- Once recognised, it is an important chance to discuss and review the person’s palliative care needs, and plan to improve their quality of life.
- Recognition can help in preparing families for the death.