Last Aid Courses as a Means for Public Palliative Care Education—A Narrative Review of the Literature and 10 Years of Experience Around the World with Implications for Future Research

Bollig, Georg; Mills, Jason; Müller-Koch, Sindy; Pani, Pandeli; Neumann, Bianca; Zelko, Erika

doi:10.3390/healthcare14010096

Open AccessReview

Last Aid Courses as a Means for Public Palliative Care Education—A Narrative Review of the Literature and 10 Years of Experience Around the World with Implications for Future Research

by

Georg Bollig

^{1,2,3,4,*,†}

,

Jason Mills

^3,5,*,†

,

Sindy Müller-Koch

^3,6,

Pandeli Pani

^3,7,

Bianca Neumann

^8,9

and

Erika Zelko

^3,10,11

¹

Department of Anesthesiology, Intensive Care, Palliative Medicine and Pain Therapy, Helios Klinikum Schleswig, 24837 Schleswig, Germany

²

Department of Palliative Medicine, Faculty of Medicine and University Hospital, University of Cologne, 50937 Cologne, Germany

³

Last Aid Research Group International (LARGI), 24837 Schleswig, Germany

⁴

Letzte Hilfe Deutschland gGmbH, 24837 Schleswig, Germany

⁵

Research Centre for Palliative Care, Death, and Dying (RePaDD), College of Nursing and Health Science, Flinders University, Adelaide 5042, Australia

⁶

Nursing Home am Lerchenberg, 06886 Wittenberg, Germany

⁷

Deutsche Welle, 53113 Bonn, Germany

⁸

Sue Ryder, London NW1 1BU, UK

⁹

International Observatory on End of Life Care, Division of Health Research, Faculty of Health and Medicine, Health Innovation One, Sir John Fisher Drive, Lancaster University, Lancaster LA1 4AT, UK

¹⁰

Institute for Palliative Medicine, Medical Faculty, University Maribor, 2000 Maribor, Slovenia

¹¹

Institute for General Medicine, Medical Faculty, Johannes Keppler University, 4040 Linz, Austria

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^*

Authors to whom correspondence should be addressed.

^†

These authors contributed equally to this work.

Healthcare 2026, 14(1), 96; https://doi.org/10.3390/healthcare14010096

Submission received: 30 October 2025 / Revised: 22 December 2025 / Accepted: 23 December 2025 / Published: 31 December 2025

(This article belongs to the Special Issue New Advances in Palliative Care)

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Abstract

Objective: To provide a narrative overview of the scientific knowledge on Last Aid Courses and experiences from different countries. Background: The levels of death literacy, grief literacy, and knowledge about palliative care are low in many countries around the world. For many people, dying, death, and grief are still a taboo. Public Palliative Care Education (PPCE), the public knowledge approach, and the Last Aid Course (LAC) aim to increase death literacy, grief literacy, and public knowledge about palliative care. Methods: A literature search in the databases PubMed/Medline, CINAHL, and PsycInfo was undertaken. Other additional sources were found by hand searching, books, reference lists, and the internet. A narrative overview of the existing literature on LAC and Public Palliative Care Education (PPCE) is provided. Experiences with PPCE and LAC from different countries are presented. Based on the findings, a future agenda for research on PPCE and LAC is presented. Results and Discussion: PPCE and LAC have been introduced in 23 countries. A total of 17 articles and reviews on Last Aid were included. Research on the effects of LAC in different countries and cultural issues connected to LAC are ongoing. Conclusions: Since 2015, LACs have been introduced in 23 different countries. The LAC, the LAC-KT, and PPCE may enhance the public debate on dying, death, grief, and palliative care and may empower people to contribute to end-of-life care in the community. Future research on PPCE, the LAC, and the LAC-KT should focus on retention over time and the long-term effects of the courses.

Keywords: palliative care; public palliative care education; end-of-life care; compassionate communities; Last Aid Course; health literacy; death literacy; grief literacy; education

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MDPI and ACS Style

Bollig, G.; Mills, J.; Müller-Koch, S.; Pani, P.; Neumann, B.; Zelko, E. Last Aid Courses as a Means for Public Palliative Care Education—A Narrative Review of the Literature and 10 Years of Experience Around the World with Implications for Future Research. Healthcare 2026, 14, 96. https://doi.org/10.3390/healthcare14010096

AMA Style

Bollig G, Mills J, Müller-Koch S, Pani P, Neumann B, Zelko E. Last Aid Courses as a Means for Public Palliative Care Education—A Narrative Review of the Literature and 10 Years of Experience Around the World with Implications for Future Research. Healthcare. 2026; 14(1):96. https://doi.org/10.3390/healthcare14010096

Chicago/Turabian Style

Bollig, Georg, Jason Mills, Sindy Müller-Koch, Pandeli Pani, Bianca Neumann, and Erika Zelko. 2026. "Last Aid Courses as a Means for Public Palliative Care Education—A Narrative Review of the Literature and 10 Years of Experience Around the World with Implications for Future Research" Healthcare 14, no. 1: 96. https://doi.org/10.3390/healthcare14010096

APA Style

Bollig, G., Mills, J., Müller-Koch, S., Pani, P., Neumann, B., & Zelko, E. (2026). Last Aid Courses as a Means for Public Palliative Care Education—A Narrative Review of the Literature and 10 Years of Experience Around the World with Implications for Future Research. Healthcare, 14(1), 96. https://doi.org/10.3390/healthcare14010096

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Last Aid Courses as a Means for Public Palliative Care Education—A Narrative Review of the Literature and 10 Years of Experience Around the World with Implications for Future Research

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