Palliative and end-of-life care

The brochure contains information to guide those caring for First Nations and Indigenous Peoples related to advanced care planning. Although created in BC, it can be applicable to Ontario residents.  

This Advance Care Planning website helps Ontarians learn about Advance Care Planning (ACP) and includes information about: having a conversations to help people and their substitute-decision-maker (SDM) towards preparing for future healthcare decisions considering what's important to you and how to involve your SDM Ontario law and substitute decision-making  © 2024 Hospice Palliative Care Ontario.   

The Bereavement Risk Assessment Tool, or BRAT, is a psychosocial assessment tool used by care teams to communicate personal, interpersonal and situational factors that may place a caregiver or family member at greater risk for a significantly negative bereavement experience.

The CANHELP caregiver questionnaire was designed to evaluate satisfaction with care for older patients with life threatening illnesses, and the family members. A straight forward satisfaction instrument that you can use t rate the quality of care at the programs or organization level. Reference: CARENET Canadian Researchers at the End of Life Network. (n.d.). CANHELP Tool.  The CARENET © 2025

The CHPCA is the national voice for hospice palliative care in Canada. Advancing and advocating for quality end-of-life/hospice palliative care, its work includes public policy, public education and awareness.   © 2024 Canadian Hospice Palliative Care Association.

This link provides information and support for professionals on palliative and end-of-life care, loss and grief.  There is a list of clinical tools and useful resources to enhance palliative and end life care.  Copyright 2003-2025 Canadian Virtual Hospice.

Goals of Care discussions help a person living with a life-limiting illness understand the serious nature of their illness. If the person is incapable, the discussions are with their substitute decision-maker. Goals of Care discussions also help healthcare providers to understand the patient’s values and goals for their care. Cancer Care Ontario

This information fact sheet is developed as a supplement to the RNAO Nursing Best Practice Guideline document for nurses. Registered Nurses’ Association of Ontario. (2011).  Care In The Last Days And Hours Of Life.  Toronto, Canada: Author. 

These Indigenous Palliative Care Fact Sheets are developed to support First Nations, Inuit, Métis and urban Indigenous people living with a life-changing illness and their families, caregivers and communities. Cancer Care Ontario. (2013). Palliative Care Toolkit for Indigenous Communities.

On Mar. 17, 2021, the federal government passed Bill C-7 to amend the Criminal Code to expand eligibility for Medical Assistance in Dying (MAID). Use the CNO site to find important updates, information and resources that impact nurses in Ontario on the subject of MAID. © 2025 College of Nurses of Ontario

Residents with severe dementia or other end stage diseases eat less as part of the natural progression of their disease. Research at end of life suggests that as residents eat and drink less they do not suffer from hunger or thirst. This session will focus on “Comfort Feeding Only” (CFO), when oral intake is not sufficient to sustain life, and if prolonging life with artificial hydration is not consistent with the residents' wishes (as expressed by the resident or their substitute decision maker (SDM)). This webinar is intended for long-term care leaders facilitating practice change and direct care staff that will benefit from understanding CFO process and the goal of the feedings to achieve comfort by employing the least invasive and potentially most satisfying way to provide nutrition. During this webinar, participants will: Understand process followed to identify gap, develop policy and implementation of CFO How to have a conversation with resident, family/SDM for comfort feeding only Learn different implementation strategies to initiate CFO Know strategies focusing on safe positioning and swallowing Recognize symptoms such as dry mouth that can be alleviated with minimal oral intake and/or oral care Presented by Dr. Evelyn Williams and Jennifer Wong - Veteran's Centre Sunnybrook Health Sciences Centre in collaboration with Registered Nurses’ Association of Ontario (2017). Comfort Feeding Only(CFO): Managing Feeding at End-of-Life. RNAO You Tube. Retrieved from https://youtu.be/OB_HMSqKcao

Figure 2 from, A Palliative Approach to Care in the Last 12 Months of Life, illustrates complex issues that persons and their families may face when receiving palliative care, which are categorized into eight equally important domains. Registered Nurses’ Association of Ontario (2020). A Palliative Approach to Care in the Last 12 months of Life. Toronto, ON: Author.

Early Identification & Prognostic Guide for Clinicians by Mississauga Halton PCN - This Early Identification and Prognostic Indicator Guide aims to help family physicians, specialist physicians and nurse practitioners in earlier identification of those patients nearing the end of life who could benefit from a palliative care approach to care. Thomas. K et al. Prognostic Indicator Guidance, 4th Edition. The Gold Standards Framework Centre In End of Life Care CIC, 2011. Adaptation of guide completed by Mississauga Halton Regional Hospice Palliative Care Committees with permission from K. Thomas Copyright © 2025 Ontario Health at Home. All rights reserved.

The brainXchange End of Life Care section contains presentation slides and resources on end of life care, including care related to persons in the final stages of dementia.  © 2025 brainXchange™

This brochure prepared by Alzheimer's Association provides support in preparing for the end of life, especially when families must make choices. © 2016 Alzheimer’s Association®

The Cancer Care website links to the guidelines for palliative care. The target population is any individual requiring palliative care. All Clinicians and staff involved in the delivery of palliative care can use this guideline.  

The Advocacy Centre for the Elderly (ACE) website provides various information related to health care consent and advance care planning, frequently asked questions and resources. Copyright © 2025 The Advocacy Centre for the Elderly (ACE).

This section of the brainXchange website focuses on health care consent and advance care planning, with many presentations and resources available to help when caring for persons at the end of life.  © 2025 brainXchange™

This guide is intended to help health care/hospice palliative care professionals and volunteers to have a conversation with and/or respond to patients or their families around Medical Assistance in Dying (MAiD). © 2024 Canadian Hospice Palliative Care Association.

The Hospice Palliative Care Ontario offers many educational resources for caregivers including Advance Care Planning and Health Care Consent for Health Service Providers. There is also a Palliative Care Core Course for Interdisciplinary staff which covers pain and symptom management, ethical decisions, communication and end of life in dementia. Materials are freely accessible. Copyright © Hospice Palliative Care Ontario 2023

Implementing a Palliative Approach to Care in Long Term Care, is an implementation guide and resource toolkit that aligns with the expanded Palliative Approach to Care requirements within the Fixing Long-Term Care Act, 2021 (FLTCA). The document is divided into 3 sections, each section starts with content related to the section’s theme, followed by a comprehensive list of resources, including hyperlinks. 1. Key concepts in a palliative approach to care 2. Mentorship, education and support to build competency and capacity 3. Implementing a palliative approach to care  

Developed by a Canadian research team who has been funded by the Canadian Institutes for Health Research to explore the ethical, policy, and practice implications of Medical Assistance in Dying for Nurses. As part of our knowledge translation strategy, a Reflective Guide for Nurses that addresses six main areas of nursing practice in relation to Medical Assistance in Dying: nurses’ experiences, making moral sense, best practices, common dilemmas, and self-care. The Reflective Guide includes a video that provides a compelling insight into a few nurses’ experiences with Medical Assistance in Dying. This free guide can be used for individual study or as part of an educational offering. Author: CIHR IRSC, Funding from CIHR: CIHR Project Grant PJT-148655; CIHR Project Grant PJT-169144

Cancer Care Ontario website links to best-practice tools from around the world to support primary care providers in the delivery of palliative care.  Tools are organized according to the 3-step model of best practice: Identify, Assess, and Plan. For resources tailored to support First Nations, Métis and Inuit families and communities, please see Tools for the Journey: Palliative Care in First Nations, Inuit and Métis Communities , a Resource Toolkit, developed by the Aboriginal Cancer Control Unit at Cancer Care Ontario.  

On June 16, 2016, the federal government passed legislation to amend Canada’s Criminal Code and established a federal framework for Medical Assistance in Dying (MAID) for individuals who meet pre-defined eligibility criteria. MAID, as defined by the Government of Canada, refers to: The administering by a medical practitioner or nurse practitioner of a substance to a person, at their request, that causes their death. The prescribing or providing by a medical practitioner or nurse practitioner of a substance to a person, at their request so that they may self-administer the substance, and in doing so, cause their own death. As part of its efforts to implement a consistent approach to the MAID process in Ontario, the Ministry of Health and Long-Term Care (MOHLTC) has engaged the Centre for Effective Practice (CEP) to develop a resource to support clinicians (physicians and nurse practitioners) with the provision of MAID.  Centre for Effective Practice. (2019). Medical Assistance in Dying (MAID): Ontario (rev).

Medical assistance in dying (MAID) has been legal in Canada since 2016. Nurse practitioners, physicians, pharmacists, and “persons aiding practitioners” (including nurses) are permitted to help those who have explicitly requested MAID. Resources: CNA Statement on the Passage of Bill C-14 (media release) Code of Ethics for Registered Nurses Palliative care and end-of-life resources © Copyright 2022 Canadian Nurses Association

This Government of Canada website provides information on what medical assistance in dying (MAID) is, who is eligible, how to make a request, the process, and who can provide medical assistance in dying. Date modified: 2025-08-27      

This quality standard addresses palliative care for adults with a serious illness, and for their family and care partners. It focuses on palliative care in all health settings, for all health disciplines, and in all health sectors. It includes information about general palliative care that applies to all health conditions. © King’s Printer for Ontario, 2024      

This guideline focuses on recommendations for adults, aged 18 years and older, who have reached the part of the illness trajectory that includes the last days and hours of life. This guideline will provide evidence- based recommendations for Registered Nurses and Registered Practical Nurses on best nursing practices for end-of-life care during the last days and hours. Registered Nurses’ Association of Ontario (2011). End-of-life care during the last days and hours. Toronto, ON: Author.

This best practice guideline (BPG) provides evidence-based recommendations to nurses and the interprofessional health team who support adults experiencing the last 12 months of a progressive life-limiting illness, and their families and caregivers.  Registered Nurses’ Association of Ontario. (2020). A Palliative Approach to Care in the Last 12 months of Life. Toronto, ON. Author.  

Strengthening a Palliative Approach in LTC (SPA-LTC), website shares tools for a palliative approach that empowers families and staff to provide personalized and high-quality care for LTC residents living with chronic and life-limiting illnesses. This approach provides individuals with a seamless transition from chronic disease management to appropriate end-of-life planning and care. A palliative approach is beneficial at any stage in a chronic illness to maximize comfort and respect a person’s wishes. Copyright © 2020 SPA LTC  

The Gold Standards Framework Proactive Identification Guidance-GSF (PIG), is a guide for clinicians to assist with earlier recognition of decline for patients considered to be in their final year(s) of life. It is used within the Gold Standards Framework (GSF) Quality Improvements Training Programmes to support earlier identification of patients, for better assessment of needs and care planning care in line with their needs and wishes. The PIG can be used to clarify triggers that help to identify patients earlier, so that care can be better planned, more proactive, anticipate patients’ needs and take into account their own wishes following a discussion related to advance care planning. © 2025 The Gold Standards Framework Centre CIO

MAID (medical assistance in dying), is an option during end of life that has substantial consequences for nursing practice. The goal of this toolkit is to facilitate how you may think about MAID as it relates to both your life and your nursing practice. This reflective Guide for Nurses examines six areas of nursing practice in conjunction to Medical Assistance in Dying: nurses’ experiences, making moral sense, best practices, common challenges, and self-care. It includes a video capturing nurses' experiences with MAID and this resources can be used in a group setting or independently.  Please note that this reflective guide was not designed to instruct you about the MAID legislation or the specific policies to guide your practice. To be competent to provide care you will need to familiarize yourself with the MAID legislation, your healthcare region policies, and your professional standards.   Research Team Credit: Barbara Pesut, Sally Thorne, Michael Banwell, Michael Burgess, Kenneth Chambaere, Madeleine Greig, Margaret Hall, Josette Roussel, Catharine J. Schiller, Janet Storch, Carol Tishelman, David Kenneth Wright Funding from Canadian Institutes for Health Research: CIHR Project Grant 

This framework offers guidance on strengthening the current model of palliative care so that individuals receive the right care, from the right provider, at the right time. It focuses on adults living with progressive, life-limiting illnesses who would benefit from palliative care, as well as the supports needed by their families and caregivers. The framework highlights the critical role of education in building palliative care capacity and underscores the importance of ensuring providers have the necessary competencies. April 2019

Ontario Palliative Care Network's Tools to Support Early Identification for Palliative Care. The aim of this document is to support providers and system level leadership in earlier identification of patients who would benefit from palliative care. April 2019