Recognising change

Recognising Change

Recognising change and that a person could benefit from palliative care is an important part of high quality care and tools that can assist with assessment are listed below. Most people will not need specialist palliative care. For those that do there is more on referral to specialist services in the palliAGED Evidence and Practice centres.

Supportive and Palliative Care Indicators Tool (SPICT)

SPICT (315kb pdf) is used to help us identify people at risk of deteriorating and dying with one or multiple advanced illnesses for holistic, palliative care needs assessment and care planning.

SPICT4ALL (317kb pdf) is a second version of SPICT with less ‘medical’ language that can be used by patients, family carers and staff working in health

Over 75 assessment

This health assessment allows a detailed investigation of an older person's health. It can be a prompt to consider the future of the person.

The Surprise Question

This simple and feasible screening test may identify patients' palliative care needs: Would I be surprised if this patient died in the next 12 months? The surprise question is included in the palliAGEDgp App which provides point of care access to a care framework centred on care planning, case conferencing and terminal care management plan (Framework Approach).

Framework Approach

This describes a three stage approach to care after identification of possible palliative care needs with the Surprise Question. Stages include: advance care planning, case conferencing and terminal management. This framework is also the basis of the palliAGEDgp App.


For additional practical guidance on patient assessment visit the CareSearch GP section.

CareSearch Clinical Evidence section on patient management provides a review of the evidence on recognising the last year of life.

Resources for Family and Friends

The booklet Supporting a Person Who Needs Palliative Care: A Guide for Family and Friends (319kb pdf) is a useful resource to introduce the subject of palliative care and what to expect.

Page updated 11 January 2024