Crossing over: transforming palliative care nursing services for the 21st century

Over the next decades, as the baby boomers age, there will be a considerable demand and need for 'end-of-life care'. At the same time, there are numerous efforts to reform health care systems with a growing emphasis on evidence-based and patient-centred care. The current dominant model of palliative nursing is not sufficient. A model of palliative care nursing service delivery nested with a chronic condition management model epitomised by collaboration, communication and values-sensitive decision support is proposed. Multiple antecedents impacting palliative care delivery for the future are explored. A description of how the conceptual framework could be used to guide implementation and evaluation of nursing services is included. Specific implications for planning and outcomes measurement are discussed.