Education from nurses supports people with a life-limiting illness

Nurses provide information and educate people in their care. This can increase knowledge and confidence in patients and families facing the challenge of life-limiting illness. Education can enhance quality of life and symptom management.

Related Resources

Nurses and nurse practitioners may provide education on a range of topics including disease-specific information, illness trajectory, treatment options, caring issues, psychosocial support, discharge planning, and preparation for a death.

A nurse practitioner may also offer diagnosis, prognosis, and treatment options.

In practice

To facilitate the person’s understanding of information you share and what it means for them, tailor the information content and delivery to their understanding and cognitive ability. Assume low health literacy and use plain language and avoid clinical jargon and acronyms. Keep in mind their psychological state and the extent of their support network.

Verbal communication

  • select or adapt information to the person’s health literacy and developmental level, this includes age, intellectual or cognitive capacity
  • select or adapt information to the person’s fluency in English or use translated resources, or an interpreter if possible. Using family members as interpreters risks them saying what they think rather than conveying accurately what has been said. It can place them under emotional or cultural stress. If using family members as interpreters, ensure that confidentiality and patient safety are considered.
  • ask the person if they would like to have someone with them to help retain important information and ask questions
  • avoid using abbreviations, and remember to explain medical terms
  • provide small amounts of information at a time and check that the person has understood before continuing

  • use the teach-back method which involves asking the person to share their understanding of instructions or information discussed and what it means for them:
      • explain the most important information in plain language
      • have the person repeat back information in their own words
      • resolve any misunderstandings or misinterpretations
      • close the conversation loop with the person expressing the information in their own words. 

Non-verbal communication

  • find a private space or making a space more private if possible and practical (e.g. closing a door, moving to a room or more private space, waiting for a space to be more calm/private, booking a meeting space)
  • limit noise and external interruptions if possible or practical (people, telephone)
  • minimise the effects of sight or hearing impairment (e.g. glasses, hearing aids, good lighting, appropriate print size for printed materials)
  • choose a time when the person is comfortable, alert and their condition is stable
  • make sure the person is mentally capable of taking part in the discussion (e.g. not confused, not distressed)
  • with the person's consent, have a relative or friend present who can listen and help ask questions
  • ensuring there is enough time to answer questions or repeat information so that it is understood – if not, make sure that another time is set
  • provide assistance for a person with cognitive impairment (e.g. a support person, a facilitator, information in a format that is accessible for the person, extra time to present information at an acceptable pace with time for the person to consider what they have heard and to express themself)
  • provide assistance from an interpreter where appropriate and organise this in advance

    • written materials allow the person to keep, re-read and share information. This may include:
        • Information about the condition and care options

        • the person’s care plan and goals of care
        • information about available services
        • information using text and/or illustrations appropriate to the person’s preference and literacy level
        • information in languages other than English
        • phone numbers of people or services they can contact if they have questions, need more information, need help after-hours or in the case of an emergency
        • eHealth technologies such as apps, text messaging, web-based on-demand education, telehealth, and audio- and videoconferencing can be useful as adjuncts to face-to-face education or for care in rural and remote areas. Sometimes eHealth technologies may be routinely used as part of practice in any setting.

    A person’s health literacy levels (how people access, understand and use health information) should guide the way and the level of information that is provided to them. Assume low health literacy and use plain language and avoid clinical jargon and acronyms. Give information in small chunks, at the person's pace and ask them to tell you what they have understood.

    The Australian Commission on Safety and Quality in Health Care (ACSQHC) has a Question Builder that can help people prepare for a doctor’s appointment and prioritise the most important questions to ask first.

    This information was drawn from the following resources:

    1. Dahlin CM. Communication and palliative nursing [Internet]. In: Wittenberg E, Ferrell BR, Goldsmith J, Smith T, Ragan SL, Glajchen M, Handzo G, editors. Textbook of palliative care communication. New York: Oxford University Press; 2015. [cited 2022 Oct 10].
    2. Dahlin CM, Wittenberg E. Communication in palliative care: An essential competency for nurses [Internet]. In: Ferrell BR, Paice JA, editors. Oxford textbook of palliative nursing. 5th ed. Oxford: Oxford University Press; 2019. [cited 2022 Oct 08].
    3. Doorenbos AZ, Jang MK, Li H, Lally RM. eHealth Education: Methods to Enhance Oncology Nurse, Patient, and Caregiver Teaching. Clin J Oncol Nurs. 2020 Jun 1;24(3):42-48. doi: 10.1188/20.CJON.S1.42-48.
    4. Kutzleb J, Reiner D. The impact of nurse-directed patient education on quality of life and functional capacity in people with heart failure. J Am Acad Nurse Pract. 2006 Mar;18(3):116-23. doi: 10.1111/j.1745-7599.2006.00107.x.
    5. Palliative Care Australia (PCA). National Palliative Care Standards 5th Edition. Canberra: PCA; 2018.
    6. Palliative Care Australia (PCA). National palliative care standards for all health professionals and aged care services: For professionals not working in specialist palliative care. Canberra: PCA; 2022.
    7. Rimmer A. Can patients use family members as non-professional interpreters in consultations? BMJ. 2020 Feb 11;368:m447. doi: 10.1136/bmj.m447.
    8. Smith JA, Zsohar H. Patient-education tips for new nurses. Nursing. 2013 Oct;43(10):1-3. doi: 10.1097/01.NURSE.0000434224.51627.8a.
    9. Yen PH, Leasure AR. Use and Effectiveness of the Teach-Back Method in Patient Education and Health Outcomes. Fed Pract. 2019 Jun;36(6):284-289.

    Page created 26 September 2022