End-of-life care

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Unit 626

September 2025

End-of-life care

The purpose of this activity is to consider the guidance patients and their families need to receive the best possible support during end-of-life care, not only physical but also social, psychological and spiritual.

The essence of good end-of-life care is careful and effective holistic symptom control and impeccable communication. It is particularly important to help the person facing the end of their life and their supporting network of family and friends to understand what is happening and what choices they have. Patients and families need guidance to receive the best possible support, not only physical but also social, psychological and spiritual. No one person can provide all these domains of care on their own, so it is important to build teams of care regardless of location.

This unit of check highlights some of the important physical symptoms that might require medical practitioner input. It discusses some of the legal and ethical issues for people and their families and helps general practitioners to reflect on how care is constructed in their particular practice location and what referral networks might be important to explore and strengthen. It seeks to highlight the important communication skills clinicians caring for people facing the end of their lives need to develop and maintain. It considers how inpatient and community care might be constructed in practice locations and explores aspects of grief and bereavement.

Care of dying patients is likely to be a component of every medical practitioner’s clinical practice to varying degrees. It is a common and vital aspect of the care that general practitioners provide.

Learning outcomes

At the end of this activity, participants will be able to:
  • undertake a comprehensive assessment of cancer pain and understand pharmacological and non-pharmacological interventions for evidence-based pain management
  • understand, assess and manage care for people facing the end of their life who are suffering nausea
  • understand the likely causes of constipation at end of life and construct a management plan
  • practice different and new ways of talking with people about their choices at the end of their life
  • build a care plan to give their patient the best opportunity to remain safely and comfortably at home, and even to die at home.

Case studies

Below is a list of the case studies found in this month's unit of check. To see how these case studies unfold and gain valuable insights into this month's topic, log into gplearning to complete the course. 

Clara, aged 77 years, has been a patient of yours for the past 10 years. Clara was diagnosed with metastatic breast cancer five years ago and since then has been seeing an oncologist and receiving systemic treatment. Recently, she has decided in conjunction with her oncologist to cease her chemotherapy because of concerns about side effects and quality of life. She has come to see you with increasing pain in her left arm.

Robert is an electrician aged 62 years with metastatic pancreatic cancer. His disease has progressed despite multiple lines of chemotherapy. He was recently discharged from oncology follow-up with a plan to receive ‘best supportive care’. He is known to the local community palliative care team.

You know from previous discussions with Robert that he would like to have end-of-life care at home. As you have known Robert and his family for many years, you have offered to do home visits as needed to assist with symptoms. Robert has scheduled a home visit today because of persistent nausea and vomiting.

Joan, aged 79 years, lives with her husband in regional Australia, serviced by a local rural general practice and hospital. She was diagnosed with primary peritoneal cancer 12 months ago and had four cycles of chemotherapy, which was stopped because of intolerable side effects of fatigue and anorexia. She then elected for best supportive care. Joan sees her general practitioner monthly and today is booked to see you as her usual doctor is on leave. She tells you she is ‘managing OK’ but has been troubled with constipation for the past three weeks. Her only significant past medical history is well-controlled hypertension on candesartan 8 mg daily. She is currently taking controlled-release oxycodone/naloxone 10 mg/5 mg twice a day, immediate-release oxycodone 5 mg four-hourly as required, an ondansetron 8 mg oral dispersible tablet three times a day as required and amitriptyline 10 mg at night. She does not smoke or drink alcohol and has no known allergies.

Jan, a woman aged 90 years, is well known to you. She presents today for a long appointment. She has recently been discharged from hospital following her third admission in the past six months for an exacerbation of chronic obstructive pulmonary disease. She currently lives with her daughter and has experienced increasing dependence on personal care. She requires a four-wheel frame for mobility and needs constant supervision. She spends most of her day in her recliner chair sleeping. She rarely leaves the house because of fatigue. She has difficulty mobilising and is often breathless. There is no history of cognitive impairment. She attends today’s appointment to discuss her future treatments.

William, aged 74 years, is a retired school principal. He has had progressive kidney failure for 20 years due to polycystic kidney disease. He had a renal transplant 15 years ago that failed 12 months ago, and now he has been receiving haemodialysis three times per week. He has a past history of pulmonary embolism and hypertension. He is presenting today because he has had two prolonged admissions to the acute hospital for septicaemia following infections of his arteriovenous fistula, which is used for dialysis access. William is spending every day following dialysis in bed with overwhelming fatigue. He wants to discuss why he is feeling so unwell and tired all the time. Fatigue is a very common symptom for many people with a serious and potentially terminal illness but particularly for people having dialysis. William’s wife, Margaret, is concerned about his small appetite and significant weight loss. He had a fall last week but did not sustain any real injury.
 

CPD

This unit of check is approved for 10 hours of CPD activity (two hours per case). The 10 hours, when completed, including the online questions, comprise five hours’ Educational Activities and five hours’ Reviewing Performance.
Educational
Activities
5
hours
Measuring
Outcomes
0
hours
Reviewing
Performance
5
hours

Complete check online

To enroll in this check unit online: 

  1. Log into myCPD home page
  2. Select 'Browse' and search for 1270415
  3. Select the course and register

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