The average survival time in long-term care is 18 months, meaning that palliative care essential for long-term care residents. A central component of palliative care is symptom management to provide a comfortable death. Symptom management could be an indicator of the quality of palliative care provision. We are exploring patterns of prescribing of end-of-life symptom management medications in long-term care homes across Ontario and Alberta. Specifically, we are analyzing health administrative data on prescriptions for symptom management medications. Additionally, we are interviewing healthcare providers and bereaved caregivers of long-term care residents to gain a better understanding of the observed prescribing patterns, and factors that may contribute to these patterns. This project will allow us to identify enablers and barriers to prescribing symptom management medications for residents nearing the end of life and help identify long-term care homes that may need additional support