Signs of deterioration

How do you recognise dying?

We have the opportunity to recognise dying in a patient with: • A potentially reversible illness that has reached their ceiling of appropriate treatment and continues to deteriorate. • A progressive, incurable illness that is deteriorating without reversible factors.

Factors to be taken into consideration include:

• The person’s underlying condition(s) • Whether reversible causes of deterioration have been ruled out or treated • Their ceiling of treatment • The rate of their deterioration

What are some signs of deterioration?

• Increasing physiological dysfunction recognised by increasing Early Warning Score • A progressive deterioration in function and reliance on assistance • Increasing fatigue, spending more time asleep • A lack of interest in food and drink • Weakness and swallowing difficulties, including an inability to swallow secretions • Changes in breathing pattern or skin colour