Despite advances in palliative care, some terminally ill patients still experience symptoms that are uncontrollable and unresponsive to conventional therapies. For those patients, palliative sedation, i.e. administering sedative drugs to induce unconsciousness, can be a last resort strategy to relieve terminal suffering. Although fairly frequently used it has raised much debate, particularly given recurring reports of improper application, suboptimal performance and poor communication. Research suggests that challenges with palliative sedation practice are particularly pervasive in nursing homes as these are less equipped or attended by highly specialized staff and where conditions are more complex and unpredictable – like in the case of dementia patients. Current practice of palliative sedation for residents in nursing homes may not always guarantee a dying process free of severe symptoms and is therefore amenable to improvement. Making use of the widely used MRC framework (phase 0-2) for developing and evaluating complex interventions, this proposal aims to develop a practice tool to improve the practice of palliative sedation in Flemish nursing homes. To achieve this, the project will entail a comprehensive literature review, a qualitative interview and focus group study with health care professionals and relatives involved, a thorough validation process and a preliminary effectiveness (proof-of-concept) study.