The development of nurses' spiritual perspective early in their preparation for practice, and the articulation and documentation of spiritual caring may enhance their spiritual caring practice. Further research on barriers to spiritual caring in acute care nursing environments is recommended.

Aim.  To identify residential aged care nurses' current knowledge of palliative care for older residents in need of end-of-life care. Background.  Recently, there has been a growing interest in the delivery of palliative care in residential aged care facilities. While it is recognized that aged care nurses do possess palliative care knowledge the actual level of their knowledge has not been well documented. Design/method.  An analytical study using a validated questionnaire tool - Palliative Care Quiz for Nursing, developed by Ross et al. [Journal of Advanced Nursing23 (1996) 126-137], combined with a demographic survey of Registered Nurses and assistants in nursing working in five high care residential aged care facilities in inner city region of Sydney, Australia. Results.  The total Palliative Care Quiz for Nursing score possible was 20. The mean score for Registered Nurses was 11.7 (SD 3.1) and for AINs 5.8 (SD 3.3), the difference between scores being significant (t = 8.7, df 95, P = 0.000). Misconceptions in palliative care were identified for both the groups of carers. Conclusion.  This research has highlighted the need for ongoing palliative care education for both the groups of primary carers. Relevance to clinical practice.  The findings of this research highlight the existing palliative care knowledge of residential aged care nurses and provides evidence for education programmes.

The care of patients whose illnesses cannot be cured places many stresses on health professionals (both generalist and specialist), and more importantly on patients and families. The complexities for all concerned in the process of referral to palliative care services should not be underestimated, however there is evidence that the referral process could be better handled by all health professionals. With greater understanding of the dynamics of care, the crisis of living with an incurable illness and dying can be lessened for patients. This article reports on a qualitative research project undertaken at a large metropolitan palliative care service and its referring public hospital. Patients and nurses were interviewed to identify issues relating to the care of patients and families newly referred to palliative care. The findings of this research identify themes in relation to the transition of patients from acute curative to palliative care services, e.g. pace and timing of the transition, fear and (mis)understanding, accepting palliative care, information and education on palliative care, and peer support and supervision for palliative care nurses.

The results of this study indicate that those carers who resent having to care for their frail older relative are susceptible to anxiety and depressive symptoms. This study supports the notion that there is a need for assessment of caregiving reactions in carers of frail older people.