Providing End-of-Life Care – Reflections from a Victorian Pharmacist
A blog by Demi Dadalias, Pharmacist and Educator.
Pharmacists have an important role in ensuring timely access to medications, promoting medicines use and safety, supporting prescribers with prescriptions, identifying drug interactions, monitoring side effects and much more.
As the scope of pharmacist practice expands, many are finding themselves stepping into new roles. In 2020, I joined Australia’s first Statewide Pharmacy. The Statewide Pharmacy Service supports Victoria’s Voluntary Assisted Dying (VAD) Act 2017. Providing compassionate care to terminally ill people was unexplainably challenging, but profoundly meaningful.
Here are some learnings from my experience navigating the complexities of end-of-life care (EOLC). The ideas presented stem from my day-to-day clinical work with people at the end of life.
Understanding the work
Transitioning into an EOLC role requires a deep understanding of palliative care principles, pharmacology, and communication skills. Unlike some other professions, we experience mortality on a daily basis. Therefore, in order to provide the best care, I needed to understand my role was to support and educate.
Every day presents new challenges for the terminally ill person, their family, and the healthcare team. In the context of my work, it helped me to think of a quote from a mentor, colleague and medical oncologist Dr. Cameron McLaren: “…[VAD] is a choice between two deaths.” That being said, a death is still a loss of a loved one, and that is never easy.
Upskilling
In preparation for my new role, I read as many books and listened to as many podcasts as I could find. It did help to an extent – however I learned very quickly that I could never become an expert in the world of a terminally ill person – or ever fully understand their suffering from this alone. My top picks for self-directed learning are:
- Foundational knowledge: End-of-Life Essentials online modules
- Practice active listening: at work or even in your personal life. Ask people what matters to them.
- Grief and bereavement training: through the Grief Australia website. They also offer clinical supervision for practitioners.
- Psychological First Aid: through Phoenix Australia. There are also Wellbeing and Self-Care resources available.
- For pharmacists: The Pharmaceutical Society of Australia is currently developing an online, self-directed palliative care foundation training program which will be available to all Australian pharmacists from May 2025.
Supporting yourself to support others
Supporting people at end of life can be emotionally taxing. I struggled, at times, watching the grieving process while providing care in a person’s home, often surrounded by friends and family (sometimes a room full of people!). To balance this, the gratitude expressed by patients, their carers, families/friends and health practitioners in EOLC is unlike any other role I have worked in.
- Debriefing: Something I believe to be essential for preventing burnout. Working out a schedule that suits your team, such as a morning and/or afternoon group reflection on the events of the day.
- Reflective writing: I found writing a (deidentified) summary of each patient interaction quite therapeutic. I would make note of an interesting comment, moment of joy, difficult question or a unique story about the person I had met that day.
- Support networks: Building relationships with colleagues and joining peer support groups can improve connectedness, reducing loneliness and social isolation.
- Talk to a health care professional: if you feel this could be beneficial. This could be a doctor, your employee assistance program, a counsellor or psychologist. I am an advocate for offering these services to all staff working in EOLC.
ELDAC have a great webpage for allied health professionals around end-of-life communication.
(Attempting to) prioritise self-care
Self-care is paramount in preventing burnout.
- Mindfulness and meditation: I am working on it, but when I give myself 10 minutes a day (especially at the end of a workday) I feel a lot better.
- Physical activity: Everyone is different. I enjoy walking in nature, strength training and picking up a new hobby (such as jiu-jitsu).
- Social connectedness: Making time for people that enrich your life.
- Journaling: Reflecting on my week, or even writing a few gratitude points has proven to be beneficial. I was always amazed at how the people I met in their last few weeks to days could find moments of happiness or something to be grateful for. This gave me perspective.
- Get enough sleep.
- Setting boundaries: Recognising personal limits is essential. Taking protected time off and honouring your own, and your team member’s work breaks prevents fatigue and burnout.
The ELDAC Self-care Room has useful resources for EOLC and aged care workers.
When I began my training as a pharmacist, I knew I wanted to help people. I had some idea that I would spend my early career doing meaningful work, yet I had no notion whatsoever that it would involve my own emotional and spiritual growth.
My hope is that through compassion and education, we are lessening the trauma associated with loss of loved ones and grief at work.

Demi Dadalias is a Melbourne-based pharmacist and educator. She is a graduate of Monash University, Faculty of Pharmacy and Pharmaceutical Sciences.