Terminal care ensures that people receive compassionate, person-centred support in their final phase of life. As someone working in aged care, you help maintain comfort by addressing physical symptoms, providing emotional reassurance, and respecting spiritual and cultural values. Your role also includes guiding families through this time, ensuring they feel informed and supported.
What I can do
Recognising signs that a person is approaching death can help ensure they receive appropriate care. Look out for:
- Changes in breathing, such as irregular or gasping breaths
- Reduced responsiveness or altered consciousness
- Cold hands and feet, or mottled skin.
Good communication is essential. You can support the person and their family by:
- Reassuring them that you will provide the care they need to keep them comfortable
- Notifying the GP and care team when an older person enters the terminal phase
- Explaining care decisions in a clear and compassionate way
- Asking about cultural and spiritual needs to ensure personalised care.
If a person deteriorates suddenly:
- Check for advance care plans or directives and follow the person’s documented wishes
- Consider whether care can be provided at home, or if hospitalisation is necessary
- Update care plans after emergencies to reflect any new priorities.
What I can learn
The palliAGED Practice Tips give helpful advice on recognising signs of imminent death. There is a version for nurses as well as one for careworkers. There are also topics on providing comfort at the end of life:
- Eye care
- Oral care
- Skin and wound care
These short videos from palliAGED’s Education on the Run series give practical guidance on what to do and expect in the final days and hours of life. Watch:
- Recognising the signs of dying (2min)
- Mouth care (2min)
- How to do a soft towel wash (3min)
Recognising the signs of dying
Explore the current research evidence on this topic by reading the Care of the Dying Person CareSearch Clinical Evidence Summary.
What I can give
If families and carers feel overwhelmed or want more information about what to expect at the end of life, these factsheets may help:
What I can suggest
Improve understanding of end-of-life care needs within the team by:
- Proactive anticipatory care, including advance care planning and the writing up of anticipatory subcutaneous medications to enable death in care homes, and only transfer to hospital if this is the preferred place of death.
- Raising awareness that recognising signs of imminent death and responding in a timely way is good palliative care practice
- Advocating for regular, scenario-based training to equip staff with skills in recognising signs of imminent dying, managing palliative care emergencies, and communicating with families.
- Ensuring training aligns with best practices and the Aged Care Quality Standards, particularly Outcome 5.7 which covers end-of-life care, symptom management, and advance care planning.
Encourage your service to provide a structured approach to end-of-life care by:
- Adopting the Residential Aged Care End of Life Care Pathway (RAC EoLCP) to guide teams in delivering consistent, compassionate support.
- Working with palliative care specialists such as Nurse Practitioners to build team confidence in providing care at the end of life.
- Recommending implementing clear protocols and after-hours support systems, to support staff in knowing what to do in palliative care emergencies.
Strengthen community-based end-of-life care support by:
- Making GPs aware of the Supporting a planned home death: The GP’s checklist (309kb pdf)
- Encouraging partnerships between aged care services and community palliative care providers to enhance home-based support
- Advocating for increased access to home-based palliative care resources, such as medications and equipment, to better support those who wish to die at home.
Page created 24 February 2025