education, end-of-life care, hospice, nursing, nursing homes, palliative care



  1. Ersek, Mary PhD, RN
  2. Kraybill, Beth Miller BSN, CHPN
  3. Hansen, Nathan R. BA


By the middle of this century, more than 40% of American deaths are expected to occur in nursing homes. This trend suggests that long-term-care staff must be prepared to deliver high-quality end-of-life care. However, studies suggest that staff working in this setting lack sufficient knowledge about hospice and palliative care. To address this problem, the investigators developed a comprehensive end-of-life curriculum and presented it to staff educators in a Train-the-Trainer workshop format. Eighty-seven participants attended the Train-the-Trainer workshop. Following the program, 87% of participants conducted at least one inservice. The most commonly used modules for preparing inservices were pain assessment and management, hospice services, and role of the nursing assistant in end-of-life care. Overall, participants rated the curriculum as very clear, comprehensive, up-to-date, and highly useful in enhancing clinical practice. Confidence in teaching end-of-life content increased significantly for participants who used the course materials to prepare and present inservice. These findings indicate the Palliative Care Educational Resource Team curriculum is an effective tool to teach palliative care in the nursing home setting.