Responding to change and deterioration

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As serious illness progresses or as the body weakens with age (which may include multiple conditions), a person will experience changes. These changes can affect how a person’s body functions, how they communicate, think, and behave.

Timely recognition that a person is deteriorating and clear communication of that possibility enables goals of care to be discussed and a plan of care developed, implemented and reviewed so care is responsive to the changing needs and preferences of the person, their family and carers. 

 The Supportive and Palliative Care Indicators Tool (SPICT) is a validated tool that you can use to assess deterioration for a range of advanced serious conditions. If you answer 'yes' to any of the questions this indicates that it is time to assess the person’s holistic needs and start planning future care with them.

CareSearch has developed interactive versions of the SPICT (315kb pdf) and SPICT4ALL (317kb pdf) forms for online use.

When to use SPICT or SPICT-4ALL

  • After an unplanned hospital admission or a decline in health status
  • For people with poorly controlled symptoms
  • To identify people who are increasingly dependent on others due to deteriorating function, general frailty and/or mental health problems for additional care and support
  • To identify people (and carers) with complex symptoms or other needs
  • To assess decision-making capacity
  • To identify people who need proactive, coordinated care in the community from the primary care team and/or other community staff and services
  • To agree, record and share an Advance/Anticipatory Care Plan.

To learn more about using this tool visit the SPICT website.