End of life care eLearning for care home liaison staff
End of life care eLearning offers residential aged care staff a structured route into palliative care, communication and practical decision-making. For care home liaison teams, it connects daily care in the facility with the knowledge of GPs, hospital clinicians and community palliative care services.
The Gloucestershire Hospitals NHS Foundation Trust eLearning portal provides local and national learning resources for NHS staff and learners. Staff can use it for induction, refresher training and policy updates, while the eLearning Helpdesk is available by phone or email for access or content assistance.
What the learning is designed to build
End of life care training should strengthen clinical judgement without turning care into a checklist. Liaison staff need to recognise when a resident is deteriorating, understand how comfort and treatment priorities differ, and know when hospital review or specialist palliative care input would be useful.
Useful modules bring together symptom assessment, communication skills, advance care planning, medicines and escalation. They should also show how these elements connect when a person cannot remain comfortably in their usual setting. Reflection on recent residents is valuable because it turns general learning into knowledge that can be applied during the next shift.
Communication, capacity and family partnership
Clear discussions about prognosis, options and preferred place of care can prevent distress and inappropriate transfers. Learning should cover decision-making capacity, fluctuating cognition, consent and the role of a substitute decision-maker. Where examples use UK terminology, Australian staff should compare them with local requirements for advance care directives, treatment plans and goals-of-care documentation.
Families may include relatives, partners, friends or cultural advisers, and their information can be invaluable. In Melbourne and Sydney, interpreters and bilingual staff may be essential for residents from culturally and linguistically diverse communities. Communication with Aboriginal and Torres Strait Islander residents and families should follow the protocols of their local health service, with time, privacy and respect built into the process.
Recognising deterioration and escalating safely
Changes in appetite, oral intake, mobility, sleep, cognition or urine output can signal approaching decline. Sudden delirium, breathing difficulty, uncontrolled pain or a marked reduction in consciousness require prompt assessment rather than an assumption that the change is part of dementia. Baseline observations and individual patterns of behaviour are more informative than a single measurement.
Escalation may involve the facility nurse, resident’s GP, after-hours medical service, hospital liaison team or community palliative care service. In an emergency, Australian staff should call 000. A structured handover should include the resident’s goals, baseline condition, recent observations, medicines, allergies, swallowing needs, advance care plan and what has already been tried. This supports a shared decision about whether hospital assessment would improve comfort or add distress.
Medicines, symptom relief and comfort
Anticipatory prescribing can allow symptoms to be managed promptly when a resident is no longer able to take regular medicines. Learning should clarify the roles of prescribing clinicians, facility nurses and community pharmacy teams, including delegation, medication administration, syringe pump competency, monitoring and documentation. Opioids and other controlled medicines require particular attention to indication, dose, breakthrough symptoms and adverse effects.
Non-medicine measures remain central to good palliative care. Repositioning, mouth care, reduced noise, familiar music, family presence and fewer routine observations may improve comfort. Skin care, pressure relief and symptom review should continue, while monitoring that no longer benefits the resident can be adjusted according to their wishes.
Reduced intake is not automatically a reason to introduce tube feeding or clinically assisted nutrition. For background on these interventions, the nutrition care resources can help staff consider treatment burdens alongside comfort priorities and documented goals of care.
Adapting the learning for Australian aged care
Australian aged care includes large metropolitan providers and smaller regional services. In Melbourne and Sydney, some facilities have on-site clinical teams and quick access to hospitals, community palliative care and specialist pharmacies. In regional New South Wales or Queensland, travel distance, pharmacy opening hours, ambulance access and after-hours GP arrangements may influence how a deterioration is managed.
Advance care directive law and substitute decision-maker paperwork differ between states, including Victoria, New South Wales and Queensland. Staff should use the current Aged Care Quality Standards, clinical governance and incident reporting requirements alongside local policies. Medication systems also vary: some facilities use resident-held medicines and visiting GPs, while others employ clinical nurses and have an on-site pharmacy.
The workforce may include agency staff, enrolled nurses, allied health professionals and personal care workers. Liaison staff need a clear escalation pathway that remains workable across shifts and qualifications. Telehealth, interpreter services and close links with local general practice can reduce delays, particularly where specialist palliative care is not based in the same town.
Practical preparation and workplace resources
Before beginning a module, check that it reflects your role, responsibilities and local escalation arrangements. Keep links to facility policies, medication guidance and clinical contacts available, and allow enough time to complete reflective activities rather than rushing through clinical scenarios.
Practice checklists for liaison work
Before starting a module:
- Confirm your role, clinical responsibilities and local escalation contacts.
- Gather current advance care planning and medication policies.
- Check protected time, device access and accessibility requirements.
During a care episode:
- Compare learning points with recent residents and local workflows.
- Record one change to handover, escalation or shared planning.
- Discuss unfamiliar medicines or devices with the responsible clinician.
The comparison below highlights how responsibilities can complement one another across care settings:
| Care need | Residential aged care | Hospital team |
|---|---|---|
| Primary focus | Daily comfort, baseline observations and family presence | Acute assessment, treatment and safe discharge planning |
| Information handover | Updates on intake, delirium, mobility, skin and goals | Medicines, allergies, investigations and current care plan |
| Escalation | Facility nurse, GP and after-hours service; 000 for emergencies | Ward clinician, liaison clinician and palliative care team |
| Shared outcome | An agreed approach that protects comfort and preferences | A discharge plan reflecting preferences and care home capacity |
After completing the learning, review the relevant policy, discuss one case with a colleague and identify how escalation contacts work outside business hours. The portal’s wider learning catalogue may also contain modules on communication, medicines, dementia, safeguarding and clinical deterioration. For help with navigation or technical access, contact the eLearning Helpdesk by phone or email.
Turning learning into confident practice
Completion is the beginning of safer practice, not the end of learning. Staff need opportunities to observe experienced colleagues, rehearse difficult conversations and review recent cases without judgement. Regular team discussions can reveal where local processes create avoidable delays or inconsistent information sharing.
The practical takeaway is to turn each completed module into one verified action: a clearer care plan, safer handover, earlier escalation or better-supported conversation during the next shift.