Palliative care is aimed at improving the quality of life for patients experiencing life-threatening illness through the prevention and relief of suffering. Evidence suggests that patients with non-malignant disease experience distressing symptoms at end-of-life. Although palliative care is most often associated with cancer, research is moving beyond oncology to include non-malignant conditions such as end-stage renal disease. Specialists in palliative care offer expertise in pain and symptom management in addition to psychosocial support for patients and their families. Extending palliative care beyond the oncology area makes better end-of-life care achievable for nephrology patients.

A collaborative model of care, where palliative specialists work closely with disease-specific nurses has the potential to enhance care delivered at end-of-life to patients and families. One such model was created at a large tertiary hospital in Toronto, Canada. Advanced practice nurses specializing in palliative care formed a partnership with an advanced practice nurse specializing in nephrology to improve the care of patients with end-stage renal disease. The primary goals for this collaborative were to address pain and symptom issues in a timely and effective manner for this group of patients and promote increased referrals to the palliative care team. This meant that in addition to providing end-of-life care for patients electing to withdraw from dialysis, excellent palliative care would be provided to patients electing to continue dialysis at end-of-life. Secondary goals for the collaborative were to facilitate sharing of knowledge among advanced practice nurses, and the dissemination of education on end-of-life care to nephrology nurses providing patient care.