📋 Key Information Summary
- The terminal phase is defined as the final days of life (typically ≤72 hours) when death is expected and the clinical trajectory is irreversible.
- A consistent, compassionate approach prioritising comfort over curative intervention is the cornerstone of end-of-life care.
- Ceilings of care should be documented clearly in the medical record, including limitations on escalation, ICU transfer, and cardiopulmonary resuscitation.
- Goals-of-care conversations should be led by a senior clinician, involve the patient (where able), family, and multidisciplinary team, and be documented using a standardised form (e.g., National Consensus Statement).
- Rationalise medications: discontinue non-essential treatments, convert to subcutaneous routes where oral intake is no longer possible.
- Anticipatory prescribing of subcutaneous syringe drivers for pain, nausea, agitation, and respiratory secretions reduces crisis interventions.
- Manage terminal restlessness with midazolam; manage pain with subcutaneous morphine or an equivalent opioid titrated to effect.
- Death rattle (terminal secretions) is managed with glycopyrrolate or hyoscine butylbromide — reassure families that it is not distressing to the patient.
- Preferred place of death should be explored early; most Australians prefer to die at home or in a hospice, yet the majority die in hospital.
- Family and carer support — including psychosocial, spiritual, and bereavement care — must be integrated from the outset.
- Aboriginal and Torres Strait Islander communities have specific cultural practices around death and dying; cultural safety and self-determination must be prioritised.
- After-death care includes timely certification, respectful handling of the body, and referral to bereavement services for the family.
Introduction & Australian Epidemiology
Care in the last days of life — also termed the terminal phase or active dying — encompasses the clinical, emotional, and organisational processes that support a person in the final hours to days before death when that death is anticipated. The focus shifts decisively from disease-modifying treatment to comfort, dignity, and the support of family and carers.
In Australia, approximately 170,000 people die each year (Australian Bureau of Statistics, 2023). The majority of deaths occur in hospital (54%), with around 20% at home, 14% in residential aged care, and 6% in hospice or palliative care units (AIHW, 2022). However, surveys consistently show that 60–70% of Australians would prefer to die at home — a significant gap between preference and reality.
Palliative care in Australia is delivered across all settings — specialist palliative care services, general practice, aged care, and hospital-based teams. The National Palliative Care Strategy 2018 and the Palliative Care Australia National Consensus Statement: Essential Elements for Safe and High-Quality End-of-Life Care provide the framework for best practice.
Important: Recognising the terminal phase early allows timely goals-of-care discussions, anticipatory medication prescribing, and family preparation — reducing distressing emergency interventions in the final hours.
This topic addresses four key domains: preparing for death, defining goals and ceilings of care, exploring preferred place of death, and supporting family and carers. Symptom management specific to the terminal phase is covered to the extent necessary for safe, comfort-focused care.
Preparing for Death
Recognising the Terminal Phase
The terminal phase is generally defined as the period when death is expected within hours to a few days (typically ≤72 hours). Clinical indicators include:
- Progressive decline in conscious state — from drowsiness to semi-coma to unresponsiveness
- Decreasing oral intake and dysphagia
- Peripheral cyanosis, mottling of skin (livedo reticularis), cool extremities
- Cheyne-Stokes or irregular breathing patterns
- Urinary output declining or absent
- Restlessness or agitation (terminal restlessness)
- Death rattle — pooled secretions in the upper airway
Early Signs
Days Before Death
Increasing sleep, reduced appetite, social withdrawal, mild confusion, restlessness.
Setting: Home / Hospice / Ward
Intermediate Signs
Hours to Days Before
Semi-conscious, minimal fluid intake, peripheral mottling, irregular breathing, death rattle.
Setting: Ward / Hospice / Home with support
Imminent Death
Minutes to Hours
Unresponsive, absent reflexes, apnoeic episodes, terminal gasping, loss of radial pulse.
Setting: Any — ensure comfort measures in place
Clinical Actions at the Onset of the Terminal Phase
1
Communicate with the team
Inform all members of the treating team, nursing staff, and allied health that the terminal phase has been recognised. Document in the medical record.
2
Meet with family / carers
Hold a family meeting (ideally led by a senior clinician) to explain the clinical situation, what to expect, and the comfort-focused plan. Use plain language.
3
Review and rationalise medications
Cease non-essential medications (e.g., statins, antihypertensives, prophylactic medications not relevant to comfort). Convert essential medications to subcutaneous routes.
4
Commence anticipatory prescribing
Prescribe PRN subcutaneous medications for pain, nausea/vomiting, agitation, and respiratory secretions (see drug cards below). Consider a syringe driver.
5
Cease routine observations
Routine vital signs, blood tests, blood glucose monitoring, and IV fluid therapy should generally be ceased unless directly relevant to comfort.
6
Discontinue artificial nutrition and hydration
Routine IV fluids and artificial nutrition are generally not beneficial in the terminal phase and may cause fluid overload. Offer mouth care and sips if the patient desires.
Rationalising Medications
Safety: Do NOT abruptly cease benzodiazepines, opioids, corticosteroids, or antiepileptics in patients who have been on them long-term — taper or convert to subcutaneous equivalents to prevent withdrawal or seizure.
| Cease | Continue / Convert | Consider |
|---|---|---|
| Statins, antihypertensives (unless comfort-relevant), oral bisphosphonates, antidiabetic medications (metformin, sulfonylureas, SGLT2i), prophylactic antibiotics, regular bowel medications (switch to PRN) | Opioids (convert oral → SC equivalent), corticosteroids (dexamethasone SC), antiepileptics (levetiracetam SC/IV if needed), antipsychotics (haloperidol SC), anxiolytics (midazolam SC), anticoagulants (discuss risk–benefit) | Anti-emetics (ondansetron SC, metoclopramide SC, haloperidol SC), glycopyrrolate SC for secretions, hyoscine butylbromide SC for secretions/cramps |
Goals & Ceilings of Care
Defining Goals of Care
Goals of care are the shared understanding between the patient, family, and treating team about what the treatment aims to achieve in the context of the patient's prognosis, values, and preferences. In the terminal phase, the overarching goal shifts to comfort and dignity.
In Australia, the National Consensus Statement: Essential Elements for Safe and High-Quality End-of-Life Care (ACSQHC, 2015) mandates that all healthcare organisations have processes for:
- Identifying people who are approaching the end of life
- Communicating with patients, families, and carers about dying and death
- Developing and documenting goals of care
- Supporting high-quality end-of-life care consistent with those goals
Ceilings of Care
A ceiling of care defines the maximum level of intervention that will be provided. Documenting ceilings of care prevents inappropriate escalation and ensures that care is aligned with the patient's wishes and clinical situation.
| Decision | Terminal Phase — Typical Recommendation | Documentation |
|---|---|---|
| CPR / Resuscitation | Not for resuscitation (NFR / DNAR). Cardiac arrest in the terminal phase is the final event of the dying process — CPR is futile and may be traumatic. | Document on NFR form per state/territory legislation. Ensure accessible (e.g., at bedside, in GP record, My Health Record). |
| ICU / HDU Transfer | Not indicated. Transfer to intensive care is generally inappropriate when death is expected and the focus is comfort. | Document in goals-of-care plan. Discuss with family. |
| IV Fluids / Artificial Nutrition | Generally not recommended. Evidence does not support routine hydration in the terminal phase; it may cause oedema, respiratory secretions, and discomfort. | Document rationale. Offer mouth care. |
| Antibiotics | Generally not indicated unless treating a specific symptom (e.g., distressing infected wound). Fever in the dying process is managed with paracetamol (PR/SC) or cooling. | Document decision and rationale. |
| Blood Transfusion | Usually ceased unless active bleeding causing distress and transfusion would improve comfort. | Document decision. |
| Dialysis | Withdrawal of dialysis is appropriate when consistent with goals of care. Uraemic symptoms can be managed with comfort measures. | Document with renal and palliative care teams. |
Legal note: Australian law recognises that adults with decision-making capacity may refuse treatment. For patients without capacity, treatment decisions should be made in the patient's best interests, guided by known wishes, advance care directives, and substitute decision-makers as per state/territory guardianship legislation.
Advance Care Planning
Ideally, advance care planning (ACP) discussions have occurred prior to the terminal phase. If an Advance Care Directive (ACD) exists, it should be reviewed and its directives followed. If ACP has not occurred, it is still appropriate to document goals of care during the terminal phase. The Advance Care Planning Australia (acpa.org.au) framework provides resources for clinicians and consumers.
Key Goals-of-Care Conversation Points
- "We have reached a point where the treatments we have been using are no longer able to cure or control the disease."
- "Our focus now is on making sure [patient] is comfortable, free from pain, and surrounded by the people who matter most."
- "We will continue to look after [patient] very carefully — nothing is being 'stopped' except treatments that would not help and might cause harm."
- "We would like to talk about what matters most to [patient] so that we can honour those wishes."
Preferred Place of Death
The Importance of Place
Dying in one's preferred place is associated with greater satisfaction for patients and families, reduced distress, and better bereavement outcomes. In Australia, the majority of people express a preference to die at home, yet most die in hospital — a disparity that represents a significant challenge for the health system.
| Setting | Preference (survey data) | Actual Deaths | Considerations |
|---|---|---|---|
| Home | 60–70% | ~20% | Requires 24/7 carer availability, community palliative care support, GP involvement, access to medications. May not be feasible if symptoms are complex or carer burden is unsustainable. |
| Hospice / Palliative Care Unit | 15–25% | ~6% | Specialist palliative care, optimal symptom management, family-friendly environment. Limited beds — access depends on availability and timing. |
| Hospital (general ward) | 5–10% | ~54% | May be the default if death is unexpected or occurs during an acute admission. Palliative Care Consultation Liaison teams should be involved early. |
| Residential Aged Care | 5–10% | ~14% | The "home" for many older Australians. Staff may need education in terminal care. Links with community palliative care services are essential. |
Facilitating Preferred Place of Death
- Ask early and ask again — preferences may change as the illness progresses. Document preferences in the goals-of-care plan.
- Coordinate services — community palliative care, GP after-hours services, specialist palliative care outreach, equipment hire (hospital bed, syringe driver), and pharmacy support.
- Ensure medication access — anticipatory medications must be available 24/7. The Palliative Care Pharmacy Scheme (where available) and community pharmacies with after-hours arrangements are critical.
- Respite for carers — if the patient is dying at home, arrange respite or additional carer support to prevent carer collapse.
- Transfer planning — if the patient is currently in hospital and wishes to die at home, timely discharge planning (ideally within 24–48 hours of the decision) with appropriate community supports is essential.
- Accept that plans may change — sometimes symptoms escalate and the preferred place of death becomes unfeasible. Sensitivity and honest communication are paramount.
Tip: The Australian Institute of Health and Welfare (AIHW) End-of-Life Data reports show that hospital deaths are decreasing over time as community-based palliative care expands. However, regional and rural access remains significantly lower than metropolitan access.
Family / Carer Support
The Role of Family and Carers
Family and carers are central to end-of-life care in Australia. They provide emotional support, assist with personal care, interpret the patient's wishes, and often serve as the primary link between the patient and the healthcare team. Supporting them is not optional — it is a core component of high-quality end-of-life care.
Preparing Families for What to Expect
Families often fear the unknown. Clear, honest, compassionate communication about the dying process reduces anxiety and helps them feel prepared. Key points to discuss:
- Decreasing consciousness — "It is normal for [patient] to sleep more and become less responsive. They may still be able to hear you — hearing is thought to be the last sense to fade."
- Reduced intake — "The body is shutting down and [patient] no longer needs food or fluids. Forcing fluids may cause discomfort. We will keep the mouth moist and comfortable."
- Changes in breathing — "Breathing may become irregular, with pauses (Cheyne-Stokes breathing). This is normal and does not indicate distress."
- Death rattle — "You may hear a rattling sound. This is caused by secretions in the back of the throat. It is distressing for families to hear but is generally not uncomfortable for the patient."
- Restlessness — "Some people become restless. We have medications to help with this and will use them promptly."
- Mottling and cool extremities — "The skin may become mottled or bluish, especially the hands and feet. This is a normal part of the dying process."
Emotional and Psychological Support
- Acknowledge the family's distress — "This is an incredibly difficult time. We are here to support you as well as [patient]."
- Encourage families to express their feelings, say what they need to say, and be present (or not) as they choose.
- Involve social work, pastoral care / spiritual care, and counselling services early.
- Screen for carer distress and burnout, particularly in the home setting.
- For children in the family, provide age-appropriate information and involve paediatric psychosocial services or specialised bereavement programmes (e.g., Feel the Magic, Skylight).
Spiritual and Cultural Care
Spiritual care is not limited to formal religious practice. It encompasses meaning-making, connection, legacy, and peace. Chaplaincy and pastoral care services should be offered regardless of religious affiliation. For Aboriginal and Torres Strait Islander families, specific cultural protocols around death and dying must be respected (see ATSI section).
After-Death Care and Bereavement
1
Certify death
A medical practitioner should attend to confirm and certify death. Provide the family with time to be with the body — there is no rush.
2
Provide a death certificate
Complete the Medical Certificate of Cause of Death per state/territory requirements. Explain the process to the family.
3
Organ and tissue donation
If the patient was a registered organ donor or the family raises this, contact the DonateLife team. Most end-of-life donors will not meet criteria for organ donation, but tissue donation may be possible.
4
Bereavement referral
Refer family to bereavement services — palliative care bereavement programmes, community services, GP follow-up, and specialist grief counselling where indicated. High-risk families (sudden death of a young person, complicated grief, mental health history) should be flagged.
Key Australian Support Resources for Families
| Service | Description | Contact |
|---|---|---|
| Palliative Care Australia | National peak body — consumer information, service directory | palliativecare.org.au |
| GriefLine | National telephone and online grief support | 1300 845 745 / griefline.org.au |
| Beyond Blue | Mental health support including for carers | 1300 22 4636 / beyondblue.org.au |
| Carers Australia | Support for carers including counselling, respite | 1800 242 636 / carersaustralia.com.au |
| Lifeline | Crisis support | 13 11 14 / lifeline.org.au |
Symptom Management in the Terminal Phase
Effective symptom management in the terminal phase relies on anticipatory prescribing, regular assessment, and the subcutaneous route (intermittent injection or continuous syringe driver). Oral medications should be converted to subcutaneous equivalents as swallowing deteriorates.
Subcutaneous Syringe Driver (Continuous Subcutaneous Infusion)
A syringe driver (e.g., CADD-MS 3, Graseby MS26) delivers medications continuously via a subcutaneous cannula, typically in the anterior thigh, abdominal wall, or upper arm. It is the mainstay of symptom control in the terminal phase when the oral route is lost.
Compatibility: Not all drugs are compatible for mixing in a syringe driver. Consult the Palliative Care Therapeutic Guidelines or your local palliative care service for compatibility charts. Common compatible combinations include morphine + midazolam + haloperidol + hyoscine butylbromide (quadruple driver).
Pain
Morphine (SC)
MS Contin® / Ordine® · Opioid analgesic
Adult dose
Opioid-naive: 2.5–5 mg SC PRN q4h + breakthrough dose; Syringe driver: 10–30 mg/24h SC (titrate). Convert oral:SC ratio approximately 2:1 to 3:1.
Paediatric dose
100–200 microg/kg SC q4h (opioid-naive); consult paediatric palliative care.
Renal adjustment
Reduce dose and/or extend interval if eGFR <30 mL/min. Active metabolites (M6G) accumulate. Consider fentanyl or hydromorphone in renal impairment.
PBS status
✔ PBS General Benefit
Fentanyl (SC / Transdermal)
Durogesic® / Sublimaze® · Opioid analgesic
Adult dose
SC: 25–50 microg/h via syringe driver (for renal impairment or morphine intolerance); Transdermal patches: convert from morphine equivalent — not suitable for rapid dose changes in terminal phase.
Renal adjustment
Preferred opioid in significant renal impairment — no active metabolites.
PBS status
✔ PBS General Benefit (injection); Authority Required (patches)
Nausea and Vomiting
Haloperidol (SC)
Serenace® · Dopamine antagonist (anti-emetic)
Adult dose
0.5–1 mg SC PRN q8h or 0.5–2 mg/24h in syringe driver
Note
First-line for opioid-induced nausea, metabolic nausea, and nausea related to visceral distension.
PBS status
✔ PBS General Benefit
Metoclopramide (SC)
Maxolon® · Prokinetic / D2 antagonist
Adult dose
10 mg SC PRN q6h or 30–60 mg/24h in syringe driver
Note
Useful for gastric stasis and nausea. Avoid in bowel obstruction.
PBS status
✔ PBS General Benefit
Ondansetron (SC)
Zofran® · 5-HT3 antagonist
Adult dose
4–8 mg SC q8h PRN (not usually in syringe driver)
Note
Reserve for refractory nausea. May cause constipation.
PBS status
✔ PBS General Benefit
Terminal Restlessness / Agitation
Important: Always consider reversible causes of agitation before attributing it solely to the terminal phase — urinary retention (check bladder), constipation/impaction, uncontrolled pain, medication effects (opioid toxicity), and hypoxia may be correctable.
Midazolam (SC)
Hypnovel® · Benzodiazepine (sedative)
Adult dose
2.5–5 mg SC PRN q1h for acute agitation; Syringe driver: 10–30 mg/24h SC (titrate up to 60 mg/24h if needed)
Note
First-line for terminal restlessness. Titrate to effect — the goal is comfort, not specific level of sedation.
PBS status
✔ PBS General Benefit
Levomepromazine (SC)
Nozinan® · Phenothiazine (sedative / anti-emetic)
Adult dose
6.25–12.5 mg SC q8h or 25–50 mg/24h in syringe driver
Note
Second-line for refractory agitation. Has anti-emetic properties. More sedating than haloperidol.
PBS status
Authority Required
Respiratory Secretions (Death Rattle)
Hyoscine Butylbromide (SC)
Buscopan® · Antimuscarinic
Adult dose
20 mg SC PRN q4h or 60–80 mg/24h in syringe driver
Note
Does NOT cross the blood–brain barrier significantly — less sedation. First-line for secretions.
PBS status
✔ PBS General Benefit
Glycopyrrolate (SC)
Robinul® · Antimuscarinic (quaternary ammonium)
Adult dose
100–200 microg SC PRN q4h or 0.6–1.2 mg/24h in syringe driver
Note
Alternative to hyoscine butylbromide. Does not cross the blood–brain barrier. Less tachycardia than hyoscine.
PBS status
Authority Required (injection); ✔ PBS General Benefit (oral)
Non-Pharmacological Measures
- Positioning: Semi-recumbent (30–45°) may ease dyspnoea and reduce secretion pooling. Regular gentle repositioning for comfort (not pressure area care protocols per se).
- Mouth care: Regular moistening of the lips and mouth with swabs, water spray, or lemon-glycerine swabs. Ice chips if tolerated and desired.
- Environment: Calm, quiet, familiar. Dim lighting if preferred. Music. Presence of loved ones. Minimise unnecessary clinical interruptions.
- Secretion management: Suctioning is generally NOT recommended — it can be distressing and is usually ineffective. Reposition and use pharmacological agents.
- Oxygen: Routine oxygen is generally not recommended for comfort in the terminal phase unless the patient has documented benefit (e.g., dyspnoeic from hypoxia). Cool air from a fan may be more effective for the sensation of breathlessness.
Special Populations
Paediatrics
Neonatal and paediatric end-of-life care requires a specialised multidisciplinary team, including neonatal/paediatric palliative care specialists.
Dosing of opioids and sedatives is weight-based and must be calculated carefully (e.g., morphine 100–200 microg/kg SC q4h; midazolam 50–100 microg/kg SC PRN).
Family-centred care is paramount — parents should be supported to remain with their child and to participate in care.
Sibling support and child life therapy should be offered.
pop-note: Referral to a specialised paediatric palliative care service (e.g., Bear Cottage, Very Special Kids, Hummingbird House) is strongly recommended.
Pregnancy
End-of-life care in pregnancy is rare but exceptionally complex. Decisions must consider the welfare of the mother and, if viable, the fetus.
Most opioids and benzodiazepines are compatible with comfort care in this setting — the principle is maternal comfort.
Multidisciplinary involvement (obstetrics, neonatology, palliative care, ethics) is essential.
Advance care planning should include wishes regarding the pregnancy (e.g., delivery before death if desired and feasible).
Elderly / Residential Aged Care
Many older Australians die in residential aged care facilities (RACFs). Staff education in recognising the terminal phase and managing symptoms is critical.
Opioid doses should start lower and titrate cautiously due to altered pharmacokinetics. Morphine 1.25–2.5 mg SC PRN is a reasonable starting dose.
Syringe drivers can be managed in RACFs with appropriate training and support from community palliative care or the GP.
Polypharmacy rationalisation is especially important — many residents will be on 10+ medications.
Ensure the RACF has an after-hours medication supply and escalation pathway.
Renal Impairment
If dialysis is being withdrawn, the terminal phase begins once dialysis ceases. Survival is typically 7–14 days (shorter with cardiovascular comorbidity).
Opioid choice: fentanyl or hydromorphone preferred over morphine (no active metabolites). If morphine is used, reduce dose significantly.
Midazolam is safe in renal failure. Haloperidol is generally safe but use lower doses.
Gabapentin and pregabalin should be ceased — significant accumulation.
Hepatic Impairment
Opioids: reduce dose and extend interval. Morphine clearance is reduced in hepatic failure. Fentanyl or alfentanil may be preferred.
Midazolam: use with caution — prolonged sedation. Haloperidol: use with caution — risk of hepatotoxicity.
Paracetamol: maximum 2 g/day in severe hepatic impairment.
Ascites-related discomfort may require therapeutic paracentesis if consistent with goals of care.
Immunocompromised
In patients with HIV/AIDS, haematological malignancy, or post-transplant, the terminal phase may be complicated by infection, bleeding, and multi-organ dysfunction.
Antimicrobials should be reviewed — if consistent with comfort goals, they may be ceased. If infection is causing distressing symptoms (e.g., fever, wound infection), short courses may be appropriate.
Bleeding: anticipatory prescribing of tranexamic acid (1 g IV/SC q8h) and a dark towel at the bedside. Avoid alarming the family — prepare them for this possibility.
HIV-specific: ensure ART is reviewed (usually continued for comfort if tolerated, or ceased if consistent with goals).
Aboriginal and Torres Strait Islander Health Considerations
Aboriginal and Torres Strait Islander Health
End-of-life care for Aboriginal and Torres Strait Islander peoples must be delivered with cultural safety, self-determination, and respect for cultural protocols around death and dying. Death is understood within diverse cultural and spiritual frameworks, and there is significant variation across communities.
Cultural Considerations
- Naming and speaking about death: In many Aboriginal communities, it is culturally inappropriate to speak the name of a deceased person or to display photographs. Health professionals must ask the family about these protocols and respect them.
- Sorry Business: Death triggers Sorry Business — a period of mourning with specific cultural practices. Extended family and community members may travel significant distances to be present. Flexible visiting and accommodation support should be provided.
- Country: Many Aboriginal people express a strong desire to return to their Country (traditional lands) to die. Facilitating this is a profound expression of culturally safe care but requires coordination with remote health services (e.g., Remote Area Health Corps, Royal Flying Doctor Service).
- Traditional healing: Some patients and families may wish to incorporate traditional healing practices alongside Western medicine. This should be supported where safe and feasible.
- Sorry camp / isolation: In some communities, the dying person and close family may prefer a degree of isolation. This should be understood as a cultural practice, not abandonment.
Barriers and Access
Key Australian Resources
- RHDAustralia — Palliative care resources for health professionals working with Aboriginal and Torres Strait Islander peoples (rhda.org.au).
- Palliative Care Australia: "Palliative Care and Aboriginal and Torres Strait Islander Communities" — best practice guide.
- Aboriginal Community Controlled Health Organisations (ACCHOs) — NACCHO and state/territory affiliates provide culturally safe health care including end-of-life care.
- Caring for the Dying Aboriginal Person — Clinical Yarning resources (WA Country Health Service).
📚 References
- 1. Australian Commission on Safety and Quality in Health Care (ACSQHC). National Consensus Statement: Essential Elements for Safe and High-Quality End-of-Life Care. Sydney: ACSQHC; 2015.
- 2. Australian Government Department of Health. National Palliative Care Strategy 2018. Canberra: Commonwealth of Australia; 2018.
- 3. Australian Institute of Health and Welfare (AIHW). Palliative care services in Australia. AIHW; 2022.
- 4. Palliative Care Australia. National Palliative Care Standards. 5th ed. Canberra: Palliative Care Australia; 2018.
- 5. CareSearch. Palliative Care Evidence — Terminal Phase. Flinders University, Adelaide. caresearch.com.au. Accessed 2024.
- 6. Royal Australian College of General Practitioners (RACGP). Medical care of older persons in residential aged care facilities. 4th ed. Melbourne: RACGP; 2006 (updated 2022).
- 7. National Health and Medical Research Council (NHMRC). Decision-Making at the End of Life for People with Dementia. Canberra: NHMRC; 2018.
- 8. Advance Care Planning Australia (ACPA). National Framework for Advance Care Planning. Melbourne: ACPA; 2023. acpa.org.au.
- 9. RHDAustralia. Palliative Care for Aboriginal and Torres Strait Islander Health Practitioners. Darwin: RHDAustralia; 2021.
- 10. World Health Organization (WHO). Palliative Care Fact Sheet. Geneva: WHO; 2020.
- 11. National Institute for Health and Care Excellence (NICE). End of life care for adults: service delivery. NICE guideline [NG142]. London: NICE; 2019.
- 12. Currow DC, Agar M, Sanderson C, Abernethy AP. Populations who die without specialist palliative care: does lower uptake equate with unmet need? Palliative Medicine. 2008;22(1):43–50.
- 13. Tieman JJ, Sladek R, Currow D. Changes in the quantity and level of evidence of palliative care published literature 1990–2009. Journal of Pain and Symptom Management. 2011;41(6):1057–1065.
- 14. Australian Bureau of Statistics (ABS). Causes of Death, Australia, 2022. Canberra: ABS; 2023.
- 15. Palliative Care Australia. Palliative Care and Aboriginal and Torres Strait Islander Communities: A Guide for Health Professionals. Canberra: Palliative Care Australia; 2021.