Level 3 End of Life & Palliative Care – Advanced Practice

Experienced adult care workers need to distinguish changing needs from assumptions about dying, follow individual plans and obtain timely clinical advice. This course develops those judgements through practical scenarios and guided records. Fifteen teaching Modules, guided reading, two applied case studies and a supervision exercise support deeper learning. Main context: England adult social care. Distinguish applicable England duties from England-and-Wales law and local practice. This is advanced non-regulated Level 3 training, not an RQF qualification or clinical competence sign-off.

👥 What you need

Experience of adult care practice, access to an internet-enabled device and time for the teaching, guided reading and applied tasks. Use current local procedures alongside the course and anonymise discussion examples.

⏱ Learning time

Allow approximately 4 hours 53 minutes for the course, including teaching videos, guided self-study activities and the final assessment.

📘 Module 1 — Understanding Palliative and End of Life Care

Palliative care addresses physical, emotional, social and spiritual needs alongside treatment for life-limiting illness. End-of-life care is broader than the final days; support may be needed over many months.

By the end of this module, learners will be able to:

✓ Distinguish palliative support from care in the last days of life
✓ Explain the care worker's contribution to each.

Workplace application: Arthur has COPD and wants to remain in his care home. Record his preference and arrange review with the responsible team about what support is feasible, emergency contacts and circumstances requiring reassessment. Do not promise that hospital transfer will never be needed.

📘 Module 2 — Person-Centred Values and Cultural Needs

Ask people what matters to them, including privacy, food, language, faith, relationships and how they wish to be supported. A cultural identity does not establish an individual preference.

By the end of this module, learners will be able to:

✓ Identify personal, cultural and spiritual preferences
✓ Show how these inform an individual care plan.

Workplace application: Priya’s relatives request particular food and rituals. Speak with Priya privately where appropriate and establish her own preferences. Agree what staff can provide, what specialist advice is needed and who will coordinate arrangements.

📘 Module 3 — Recognising Changing Needs and Deterioration

Compare current presentation with the person’s usual condition. Changes in alertness, breathing, mobility, intake, pain, skin or behaviour may signal deterioration and require review.

By the end of this module, learners will be able to:

✓ Recognise changes requiring clinical review
✓ Communicate observations without making an independent diagnosis.

Workplace application: David becomes unusually drowsy and grimaces during movement. Pause distressing care, make him comfortable within the plan, record the change and contact the clinical team promptly. Use emergency services if his condition is immediately life-threatening; do not label the change “expected decline” without review.

📘 Module 4 — Communication and Difficult Conversations

Use a quiet setting, introductions and the person’s preferred communication method. Ask what they understand and what they wish to discuss; allow silence and acknowledge uncertainty.

By the end of this module, learners will be able to:

✓ Use sensitive, accessible communication
✓ Identify when questions should be referred to the responsible professional.

Workplace application: George asks whether he will die that night while his daughter is distressed. Acknowledge their worry, stay within known facts and arrange a timely discussion with the responsible clinician. Ask George whom he wants involved and what support would help him participate.

📘 Module 5 — Capacity, Consent and Advance Care Planning

Consent and capacity concern a specific decision at a particular time. Presume capacity, offer practicable support and do not equate refusal with incapacity.

By the end of this module, learners will be able to:

✓ Explain decision-specific consent and capacity
✓ Distinguish advance care planning from an instruction to withdraw all care.

Workplace application: Florence expresses a future wish to refuse ventilation. Record her words and facilitate appropriate clinical discussion about a valid advance refusal. Check any existing documents and attorney authority; do not present a care-note entry or family agreement as a completed legal instrument.

📘 Module 6 — Care Coordination and Individualised Plans

An individual plan should connect the person’s goals with named responsibilities, practical support, equipment, medicines arrangements and daytime/out-of-hours contacts. Staff need access to the current version at the point of care.

By the end of this module, learners will be able to:

✓ Identify responsibilities within coordinated care
✓ Prepare a handover that reflects the person's current plan.

Workplace application: Malcolm’s nursing visit and homecare call repeatedly overlap, leaving another period unsupported. Review the schedule with him and the relevant services, agree responsibilities and confirm the revised arrangement in the care record and handover.

📘 Module 7 — Comfort, Pain and Symptom Observation

Ask about pain and other discomfort using an approach the person can understand. Where communication is limited, observe changes such as guarding, facial expression, movement or vocalisation without assuming a single cause.

By the end of this module, learners will be able to:

✓ Describe observations of pain and discomfort
✓ Report changes and support comfort within agreed instructions.

Workplace application: A resident guards her hip and cries during washing. Stop the painful movement, explain what you are doing and seek prompt clinical advice. Record the person’s words and observations; do not continue the task merely to meet the morning timetable.

📘 Module 8 — Hydration, Nutrition and Mouth Care

Offer food and drink according to the person’s wishes, abilities and current care plan. Reduced intake may occur near death, but a new change also needs assessment.

By the end of this module, learners will be able to:

✓ Identify individual nutrition, hydration and mouth-care needs
✓ Distinguish supportive care from clinical treatment decisions.

Workplace application: A son tries to force his father to eat because he fears neglect. Explain that comfort, wishes and swallowing safety guide support; offer mouth care and seek review of the change in intake. Ask the clinical team to address the family’s hydration questions.

📘 Module 9 — Medicines Support and Role Boundaries

Medicines support must follow current individual directions, staff competence and the service’s medicines policy. Confirm the person, medicine, dose, route, timing, consent and relevant instructions before administration; record what actually happened.

By the end of this module, learners will be able to:

✓ Explain medicines-support boundaries
✓ Identify when a concern requires a prescriber or other competent professional.

Workplace application: A relative asks staff to give an extra analgesic dose early. Check the existing prescription and PRN plan and seek urgent clinical advice if symptoms remain uncontrolled. Record the request and response without improvising a dose.

📘 Module 10 — Emotional, Spiritual and Family Support

People may want companionship, privacy, reconciliation, spiritual support or practical help; their needs can change. Ask rather than assuming that family presence is always helpful.

By the end of this module, learners will be able to:

✓ Identify emotional and spiritual support needs
✓ Include people important to the person with appropriate consent.

Workplace application: A husband appears exhausted and says he cannot manage another night. Listen, clarify immediate safety and contact the care coordinator for urgent support planning. Explain available carer-support routes rather than promising an unconfirmed respite placement.

📘 Module 11 — Supporting Care in the Last Days of Life

Care in the last days should remain individualised and responsive to clinical review. Follow agreed comfort, personal care, mouth care, positioning, continence and symptom plans, minimising unnecessary disturbance.

By the end of this module, learners will be able to:

✓ Recognise the need for an individual last-days plan
✓ Explain how to escalate changes or uncertainty in that plan.

Workplace application: A resident’s breathing changes and staff assume no further action is needed because a DNACPR form is present. Check the agreed plan, seek clinical review and continue appropriate comfort and other care. Explain that the form addresses CPR specifically.

📘 Module 12 — Responding to Death and Local Procedures

Follow the local expected-death or emergency procedure and the individual plan. Where death is unexpected, circumstances are unclear or emergency treatment may be needed, obtain emergency help and follow instructions.

By the end of this module, learners will be able to:

✓ Describe care-worker actions under local procedures after a death
✓ Distinguish these from clinical verification or certification.

Workplace application: Staff find a person unresponsive. They check the known plan, call the appropriate urgent service and follow instructions rather than declaring death themselves. Record when the person was found and who was contacted; arrange verification through the authorised route.

📘 Module 13 — Bereavement and Support for Those Important to the Person

Bereavement responses differ between people and over time. Offer practical information, respectful listening and an opportunity to ask questions without imposing a sequence of grief stages.

By the end of this module, learners will be able to:

✓ Identify practical and emotional bereavement support
✓ Signpost concerns beyond the worker's competence.

Workplace application: A daughter returns repeatedly with questions after her mother’s death. Arrange a named contact, explain known facts within role and offer bereavement-support information. Record unresolved clinical questions for the responsible professional.

📘 Module 14 — Safeguarding, Professional Boundaries and Staff Wellbeing

Safeguarding concerns can arise during palliative care, including neglect, coercion, financial abuse or treatment decisions made for staff convenience. Protect immediate safety, listen to the person and report through local routes.

By the end of this module, learners will be able to:

✓ Recognise safeguarding and boundary concerns
✓ Identify supervision and support needs for staff providing end-of-life care.

Workplace application: A worker is pressured to conceal a missed comfort-care visit. Preserve an accurate record, assess current needs and report the concern through a safe route. Seek support for the worker without allowing the missed care to disappear from the record.

📘 Module 15 — Documentation, Supervision and Quality Improvement

Records should show the person’s wishes, observed changes, care offered, refusals, advice obtained and what happened next. Separate facts, the person’s words and professional advice from interpretation.

By the end of this module, learners will be able to:

✓ Produce a clear care observation record
✓ Use a supervision review to identify a practical service improvement.

Workplace application: An audit finds three versions of an end-of-life plan in use. Confirm the current plan with the responsible team, replace obsolete operational copies safely and brief staff. Recheck later that staff can find and use the current instructions.