Palliative care for older people has been forced back onto the professional agenda of nurses by the technological revolution in health-care capabilities, increased public awareness of human rights issues, and a gradual change in the concept of wellbeing. In January 2003 draft guidelines for palliative care in Residential Aged Care Facilities ( RACFs) were posted on the Australian Palliative Aged Care (APAC) website (www.apacproject.org ) These guidelines were developed by a team in Western Australia following a grant from the federal government to support the production of both an education program on palliative care and guidelines in relation to palliative care for staff working in RACFs. These guidelines and the education that will accompany them will be a major step forward in the assisting nurses in the provision of palliative care for the older person. However, the dilemmas and difficulties posed by the introduction of palliative care, for a person without a malignancy and/or known time trajectory of death, will remain problematic and leave many nurses in a quandary over the right decision to make. This chapter suggests some ways of dealing with those dilemmas by focussing on problem identification, and also upon the issues to be debated before discussing the introduction of palliative-care plans or pathways for clients in both residential settings and the community. Altough there is a growing body of expert practice in this area, and although evidence-based work is developing, sadly there is as yet little evidence on which to base our practice.