Guideline 4:

Palliative and End-of-Life Care

Recognises that palliative care is appropriate at any stage of serious illness and can be provided alongside curative treatment for months or years, focusing on comfort and quality of life. Palliative Care and End-of-Life Care are areas where many aged care staff demonstrate extraordinary compassion, presence, and skill, accompanying individuals and their supporters through one of life’s most profound transitions. That care is real, significant, and matters deeply.

OVERVIEW

This section identifies areas where research and consultation suggest holistic person-centred spiritual care can be strengthened across the sector, particularly in documentation, advance care planning, cultural responsiveness, and structured support for staff. Not all of these challenges will be present in every setting, and some providers will already have strong systems and practices in place. The purpose of this section is to support ongoing reflection and improvement in an area of care that deserves continuous attention.

This Guideline builds upon all preceding Guidelines whilst addressing unique end-of-life needs. Knowing and Being Known (Guideline 1) becomes essential for understanding each individual’s beliefs about death, dying, and what a ‘good death’ would be like for them. Meaning and Purpose (Guideline 2) takes on heightened urgency as individuals engage in life review, seek reconciliation, and pursue transcendence. Connectedness and Belonging (Guideline 3) enables individuals to maintain or restore important relationships before death. Support Workforce Wellbeing (Guideline 5) requires specific support for staff navigating grief, complex decisions, and the emotional demands of accompanying dying. Diversity and Inclusion (Guideline 6) ensures culturally appropriate death rituals and practices that prevent harm and honour diverse beliefs.

This Guideline provides practical strategies for early conversations about spiritual values in advance care planning, spiritual accompaniment at the end of life, palliative care, culturally safe death practices, and support for families and staff. This delivers improved satisfaction, reduced complaints, and enhanced staff confidence whilst honouring the sacred nature of dying and death.

Who will benefit?

Individuals

receiving palliative and end-of-life care experience dignity, peace, and care aligned with their values, beliefs, and cultural needs.

Supporters

receive recognition and support for their own spiritual needs during their loved one’s dying and death, which improves outcomes for individuals as well.

Workforce

gains confidence, competence, and reduced moral distress when providing holistic spiritual care, particularly for diverse populations and those considering voluntary assisted dying.

Organisations

demonstrate improved satisfaction outcomes and reduced complaints.

What strategies will be used?

Strategy A

Advance Care Planning

Strategy B

Access existing online palliative care and end-of-life resources

Strategy C

Support individuals choosing Voluntary Assisted Dying (VAD) through holistic, person-centred spiritual care

Strategy D

Ensure all individuals have access to spiritual accompaniment

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View Guideline 4 Here

The related appendix

Guideline 4 – Palliative Care and End-of-Life Strategies	Relevant Standards	Outcomes & Key Actions Referenced	Demonstrated Alignment
Strategy A – Advance Care Planning	Standard 1; Standard 3; Standard 5; Standard 2	S1: 1.1; 1.2; 1.3 S3: 3.1.6; 3.1.1–3.1.4 S5: 5.7 (5.7.1–5.7.4); 5.4 S2: 2.7 (2.7.1–2.7.3); 2.3	Implements structured advance care planning incorporating spiritual assessment; ensures cultural and emotional safety, interpreter access and multidisciplinary collaboration; aligns with end-of-life planning, informed consent and holistic comprehensive care.
Strategy B – Access Existing Palliative and End-of-Life Resources	Standard 5; Standard 2; Standard 3	S5: 5.7; 5.4 S2: 2.2; 2.3; 2.9 S3: 3.1; 3.2.1	Strengthens organisational capability through evidence-based resources; supports workforce development, quality systems and coordinated person-centred palliative care.
Strategy C – Support Individuals Choosing Voluntary Assisted Dying (VAD)	Standard 1; Standard 3; Standard 5; Standard 2	S1: 1.1; 1.2; 1.3 S3: 3.1; 3.4 S5: 5.7; 5.4 S2: 2.3; 2.4; 2.6	Provides holistic spiritual care alongside regulatory compliance; supports meaning-making, values clarification, privacy and relational continuity; addresses staff moral distress and multidisciplinary collaboration.
Strategy D – Spiritual Accompaniment and Ritual	Standard 1; Standard 5; Standard 7; Standard 4; Standard 2	S1: 1.1; 1.2; 1.3 S5: 5.7.3; 5.7.4 S7: 7.1; 7.2 S4: 4.1b S2: 2.7	Ensures spiritual needs are embedded within end-of-life care plans; facilitates culturally appropriate rituals, sacred spaces and bereavement practices; supports external referrals and continuity of spiritual accompaniment.

Guideline 4 – Palliative Care and End-of-Life Strategies	NGSCAC Domain	NGSCAC Statement No.	Alignment Explanation
Strategy A – Advance Care Planning Integration (including spiritual dimension)	Domain III – Identifying and meeting spiritual choices, preferences and needs; Domain IV – Ethical context of spiritual care	3.2; 3.3; 3.6; 3.8; 4.1; 4.5; 4.7	Operationalises systematic exploration and documentation of spiritual beliefs, values and preferences within care planning (3.2–3.6), ensures review and responsiveness at end of life (3.8), and upholds informed consent, dignity and ethical decision-making (4.1, 4.5, 4.7).
Strategy B – Access to Palliative and End-of-Life Spiritual Care Resources	Domain I – Organisational leadership and alignment; Domain III	1.2; 1.4; 1.7; 3.6; 3.9	Strengthens organisational systems, governance and workforce capability for holistic spiritual care (1.2, 1.4, 1.7), and ensures appropriate referral pathways and specialist involvement for complex spiritual needs (3.6, 3.9).
Strategy C – Support for Individuals Choosing VAD (Holistic Spiritual Care)	Domain IV – Ethical context of spiritual care; Domain III; Domain II	4.1; 4.2; 4.5; 4.8; 3.4; 3.7; 2.2	Aligns with ethical principles including respect, non-judgement, boundaries and confidentiality (4.1–4.5, 4.8), supports exploration of existential and spiritual concerns (3.4, 3.7), and maintains relational continuity and compassionate presence (2.2).
Strategy D – Spiritual Accompaniment, Rituals and Sacred Spaces	Domain V – Enabling spiritual expression; Domain II – Relationships and connectedness	5.1; 5.2; 5.4; 5.7; 2.5; 2.9	Enables culturally appropriate spiritual rituals and practices at end of life (5.1–5.4, 5.7), and supports relational presence, shared grief and meaning-making within community (2.5, 2.9).
Strategy D – Spiritual Care Directory and External Referrals	Domain I – Organisational leadership and alignment; Domain III	1.5; 1.8; 3.7; 3.9	Formalises partnerships, referral systems and collaborative pathways (1.5, 1.8) to ensure timely access to appropriate spiritual care specialists (3.7, 3.9).

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