Supporting carers at end of life – “It’s the little things”

Miss Catherine (*Cathy) Smith1

1THS – North West, Burnie, Australia


Acute health care focuses on restoring wellness. Whilst some acute hospitals have palliative care beds, end of life care can be on any inpatient ward as a result of expected deterioration on or during admission or unexpected deterioration during admission. Research indicates over 60 % of people would prefer to die at home, yet 54 % will die in hospital.

Hospital admission for a patient approaching end of life can be after a period of home care, where the carers are often exhausted with mixed feeling about hospitalisation be it relief or guilt if home was their preferred place of care.

Feedback indicates it is often the little things that make a difference to how families and carers feel supported and cared for. A number of initiatives have been developed in the United Kingdom to support families. A logo such as a swan (used with permission) acknowledges the patient is approaching end of life.  Care packs are given to families containing items such as meal vouchers, car parking vouchers, toiletries and information about signs of life ending.

New national standards require evidence of clinical governance of end of life care including shared decision making, evidenced based best practice clinical interventions; ongoing evaluation of care and supporting patient, family and carers including staff.

Nurses have an opportunity to be innovative in their review of current end of life care. Improving satisfaction and experience to those approaching end of life and their families through “the little things” demonstrates Nurses’ caring and compassion.

Swerissen, H & Duckett, S.J (2015) What can we do to help Australians die the way they want to? The Medical Journal of Australia (MJA), 202 (1). pp.10-11. *sourced online 27/9/19

ACSQHC (2017) National Safety and Quality Health Service Standards Accreditation Workbook, Australian Commission on Safety and Quality in Health Care, Aus.

NHS, The Academy of Fabulous NHS Stuff website.                               *sourced online 24/9/19.

Lewis, J., Lilley, R. & Lock J., (2019) BEREAVEMENT – A PRACTICAL GUIDE FOR NHS MANAGERS – Including “101” Questions, IMS-Maxims, UK.


Cathy is a Project Nurse supporting the Executive Director of Nursing and Nursing Division to progress quality improvement initiatives across the THS– North West.  Her most important nursing insights have been when caring for family members, resulting in her interest in preferred place at end of life and person-centred care.