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Practice Tip Sheets for Careworkers Advance Care Planning Advanced Dementia Advanced Dementia Behavioural Changes After Death Choices Aged Care Access and Assessment Anxiety Cachexia Sarcopenia and Anorexia Case Conferences Complementary Therapies Constipation Continuity of Care Culturally Responsive Care Communication Distress at the End of Life Dysphagia Dyspnoea End of Life Care Pathways Eye Care Faecal Incontinence First Australians Communication Frailty Grief and Loss among Older People Families and Residents Grief and Loss among Staff Myths about Morphine Nutrition and Hydration Opioid Analgesics Oral Care Pain Management Palliative Care People with Intellectual Disability Communication People with Specific Needs Person Centred Care Psychosocial Assessment and Support Quality of Life Recognising Deterioration Respiratory Secretions Self Care Signs of Imminent Death Skin and Wound Care Spiritual Care Supporting Families Talking about Dying Talking within the Aged Care Team Next Steps for CareworkersPractice Tip Sheets for Nurses Advance Care Planning Advanced Dementia Advanced Dementia Behavioural Changes After Death Choices Aged Care Access and Assessment Anxiety Cachexia Sarcopenia and Anorexia Case Conferences Complementary Therapies Constipation Continuity of Care Culturally Responsive Care Communication Distress at the End of Life Dysphagia Dyspnoea End of Life Care Pathways Eye Care Faecal Incontinence First Australians Communication Frailty Grief and Loss among Older People and Families Grief and Loss among Staff Inclusive Communication for Older People with Disability Myths about Morphine Nutrition and Hydration Opioid Analgesics Oral Care Pain Management Palliative Care People with Specific Needs Person Centred Care Psychosocial Assessment and Support Quality of Life Recognising Deterioration Respiratory Secretions Self Care Signs of Imminent Death Skin and Wound Care Spiritual Care Supporting Families Talking about Dying Talking within the Aged Care Team Next Steps for NursesPalliAGED Introduction Modules Introduction Modules ManualTraining and Education palliAGED ProductsPractice Tip Sheets for CareworkersDeveloping the Workforce Supporting Change Service Solutions Download Resources Order Free ResourcesAdvance Care Planning Advanced Dementia Advanced Dementia Behavioural Changes After Death Choices Aged Care Access and Assessment Anxiety Cachexia Sarcopenia and Anorexia Case Conferences Complementary Therapies Constipation Continuity of Care Culturally Responsive Care Communication Distress at the End of Life Dysphagia Dyspnoea End of Life Care Pathways Eye Care Faecal Incontinence First Australians Communication Frailty Grief and Loss among Older People Families and Residents Grief and Loss among Staff Myths about Morphine Nutrition and Hydration Opioid Analgesics Oral Care Pain Management Palliative Care People with Intellectual Disability Communication People with Specific Needs Person Centred Care Psychosocial Assessment and Support Quality of Life Recognising Deterioration Respiratory Secretions Self Care Signs of Imminent Death Skin and Wound Care Spiritual Care Supporting Families Talking about Dying Talking within the Aged Care Team Next Steps for CareworkersPractice Tip Sheets for Nurses PalliAGED Introduction Modules Forms Resources for Families Aged Care Journeys in Palliative Care PalliAGEDnurse App Education Videos for Aged Care Workers
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 SPICT-4ALL (571kb 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?
For references and the latest version of all the Tip Sheets visit
Practice Tip sheets for careworkers
CareSearch is funded by the Australian Government Department of Health, Disability and Ageing.
Updated July 20226
Page updated 21 July 2026