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Respond to deterioration

Recognising deterioration is critical if appropriate action is to be taken. Deterioration may be slow occurring over time, or it may be rapid in onset.

Processes to monitor if a person’s condition is changing can prompt actions and care responses.

Key points

  • Signs of deterioration

  • Figuring out why they are getting worse

  • How to recognise deterioration

  • Involve the family and health care team

  • Ensure continuity of care

Signs that a person's health is getting worse may include:
  • their function is getting worse
  • feeling more tired
  • sleeping more
  • eating less
  • finding it hard to swallow
  • more pain
  • less interest in doing things or self-care.

Each person’s condition may change and get worse in a different way. They may deteriorate slowly, quickly or due to other health events. It is important to identify whether it is because of their main diagnosis or other factors or events.

Another aspect to consider is whether what they are experiencing is reversible or not. Some symptoms or conditions can be well treated or resolved, such as an acute illness or a medical emergency.

The SPICTTM  (185kb pdf) or SPICT-4ALLTM (186kb pdf) can be used to identify signs and options for response. Regular review with the SPICTTM will help adapt care, if needs change rapidly.

You will need to know what care the person or family prefers, needs or has planned. Discuss the options and consult members of the person’s health care team to agree on an approach.

Review the care plan and decide how care can be given.

It is important to also consider how after-hours medical care can be accessed if needed.

Why it is important to respond quickly

Deterioration may occur rapidly, and needs will change. You can prevent acute health problems getting worse. This may reduce distress in the end of life process for the person and family.

Have things in place:

  • understand the preferences of the person and their family
  • review the person regularly for signs of deterioration
  • identify how to have a medical review after hours
  • plan how you can offer end of life care.

Find out more

  • The SPICTTM
  • HealthPathway Resources
  • palliAGED
  • CareSearch

Visit the SPICTTM website to learn more about using the SPICTTM and SPICT-4ALLTM in your practice.

View HealthPathways clinical resources that support the care elements of the ELDAC Care Model.

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