What is palliative care?
Palliative care refers to the person-centred care provided to people who have a life-limiting condition and their families. It focuses on promoting quality of life and involves multifaceted support to meet the needs of the person and their families. This can include:
- managing physical symptoms such as pain
- advance care planning
- emotional, psychological, and spiritual support
- grief and bereavement support, and
- relevant support for families and carer(s).
You can learn more about palliative care and end of life by visiting our priority topic.
In Australia, the provision of palliative care and end-of-life care is legislated under the new Aged Care Act 2024 for the rights of older people, [1] and in particular, Outcome 5.7: Palliative care and end-of-life care of the strengthened Aged Care Quality Standards, [2, 3] which came into effect on 1 November 2025.
Why does this matter for rights-based care?
People have the right to access palliative care when they need to. With the new rights-based Act, [1] palliative care and end-of-life care is considered an integral part of aged care. To support this, Standard 5 of the strengthened Aged Care Quality Standards, [2, 3] emphasises the importance of ensuring that older people receive quality care that is evidence-based, effective, safe, and person-centred. This standard aims for care to be delivered by [2, 3]:
- supporting the older person to make decisions on aspects of care, tailored to the evolving clinical needs of the older person, and aligned with their personal goals and preferences
- ensuring timely communication at end of life
- monitoring, managing and escalating the changing needs of the older person, by recognising deterioration at the end of life
- managing pain and symptoms at the end of life using anticipatory medications, or deprescribing
- addressing increasing delirium, pressure injury risks, and daily living requirements such as oral, eye, bowel and bladder care
- engaging qualified professionals and competent aged care workers
- at all times, maintaining the older person’s comfort and dignity.
Want to learn more?
- palliAGED have steps and resources for service providers to support them to meet the requirement of the new Aged Care Act and strengthened Aged Care Quality Standards, specific to palliative care and end of life.
- ELDAC have an Aged Care Service Guide available to support service providers to meet Outcome 5.7 of the standards.
- The Knowledge and Implementation Hub have a collection of resources supporting providers to implement palliative care initiatives.
What can be done?
Supporting advance care planning
Care teams:
- Enable older people to create an advance care plan.
- Consult with substitute decision-makers where relevant to understand the preferences of the older person for their care.
The evidence:
- Advance care planning supports self-determination for older people with life-limiting illness receiving palliative care. Advance care plans have a role in care as they mandate self-determination [4] and can help healthcare professionals navigate challenges with end-of-life care and decision-making. [5]
- In palliative care practice, there can be a tension for staff when it comes to following the family or resident’s wishes. [6] An advance care plan is seen as an effective way in which residents can voice their wishes with the care team before they are unable to make decisions for themselves. [4]
- Frail older people seem to have less fear of death and dying which may be helpful to support having conversations about what they need at the end of life. [7] However, when approaching these conversations, it is important to be mindful that talking about death or dying may still be taboo in some cultures. [6]
Enabling spiritual support
Organisations:
- Facilitate training of staff on how culturally and linguistically diverse communities handle death and dying and the role of spiritual support.
The evidence:
- Understanding spiritual and/or religious beliefs that can help residents and families may support person-centred care. [7] People of different faiths and cultures may rely on spiritual and religious behaviours to cope. [7]
- Learning about someone’s cultural preferences and trauma experiences has been identified as a competency, which involves, for example, talking about end-of-life issues, understanding or coping with dying, and grief. [8]
Palliative care policies and end of life during a pandemic
Organisations or policy makers:
- Involve communities and care recipients in developing policies relating to palliative care and end of life care during pandemics or infectious disease outbreaks e.g., relating to contact with family members.
The evidence:
- Palliative care received during the pandemic in nursing homes caused confusion and distress due to the lack of contact with the outside world and the personal protective equipment worn by staff. [9]
- People have the right to palliative care. Physical contact can help to relieve stress and fear, and can be soothing for some, which is relevant at the end of life. [10] The value and importance of in-person visits to people at the end of life and their families or loved ones in situations like the pandemic should be weighed up together with risks of infection. The viewpoints of people and their families should also be considered when developing visitation policies in this context. [10]
Considerations for dying with dignity / voluntary assisted dying
Care teams:
- Be aware of relevant legislation, policies, and procedures around voluntary assisted dying (VAD) and what to do if it is raised.
- Where appropriate, support informed decision-making when it comes to VAD. To find out more about what applies to you as a worker with respect to VAD, the ELDAC End of Life Law Toolkit has a suite of resources on VAD.
The evidence:
- While palliative care does not include VAD, due to the different focus of care provided, it may come up in discussions with older people as they near the end of life. Care teams should be aware and understand the appropriate next steps in their jurisdiction. [11]
- Facilitating self-determination also demonstrates respect for autonomy in the context of dying with dignity. [12] VAD can help promote dignity in providing choice on how someone wants to die, weighing up the harms and benefits for the person. [12]