Many issues combine to enable an individual to achieve a good death. Kellie Lewis discusses these factors as well as the barriers staff must overcome

Moving from curative to palliative care is often difficult for patients, families and healthcare providers, because hospice or end of life care can be seen as a failure of healthcare teams or as patients having given up. Nurses’ role in this transition is to provide care, educate and advocate for patients, and encourage reflection on the implications of end of life. Providers face challenges in identifying when end of life begins, impaired communication in healthcare teams and feelings of guilt. Patients and families must come to terms with the idea of death while maintaining dignity.

Ensuring older patients are included in discussions can improve their quality of life and sense of dignity. Nurses can help by enabling conversations about the end of life to take place early on, improving communication between staff, and encouraging reflection by healthcare providers.