Caroline Nicholson

Professor Caroline Nicholson

Professor of Palliative Care and Ageing
PhD, MSc, BSc( Hons) RGN, FHEA
+44 (0)1483 683511



Research interests

Research projects

My publications


  • Evans, C and Nicholson, C Living and Dying in Late Old Age in Nursing Older People – Realties of Practice in Nursing Older People  (2019) ( Eds Elbourne A, H and le May, A)  Taylor and Francis  
  • Combes, S, Nicholson, CJ, Gillett, K & Norton, C (2019) 'Implementing advance care planning with community-dwelling frail elders requires a system-wide approach: An integrative review applying a behaviour change model', Palliative Medicine,
  • Evans, C,J.; Ellis-Smith,C.; Nicholson, C.;Costa, A.; Oluyase, A.O.; Namisango, E.;Bone A.E.; Brighton, L.J.; Yi,D.; Combes,S.; Bajwah,S.; Gao ,W.; Harding,R.; Higginson, I,J.; and Maddocks,M. "Rapid Scoping Review of Service Delivery Models to Maximise Quality of Life for Older People at the End of Life ", (2019) Milbank Quarterly 97, 1 p 113-175
  • Etkind,S, Lovell,N, Nicholson, C , Higginson, I. J. & Murtagh, F. F. Finding a ‘new normal’ following acute illness: A qualitative study of influences on frail older people’s care preferences (2019) Palliative Medicine 33(3) p301-311
  • Nicholson C, Davies JM, George R, Smith, B, Pace V, Harris L, Ross J, Noble J, Hansford P, Murtagh FE. (2018) What are the main palliative care symptoms and concerns of older people with multimorbidity?—a comparative cross-sectional study using routinely collected Phase of Illness, Australia-modified Karnofsky Performance Status and Integrated Palliative Care Outcome Scale data. Annals of Palliative Med Vol 7 Supplement 3, P 164-175
  • Nicholson, C. (2018) Palliative Care, Frailty and Older People in Textbook of Palliative Care. Editors in Chief- MacLeod, R and de Block, L Springer doi:10.1007/978-3-319-31738-0_66-1
  • Cheng, J.J.K and Nicholson, C (2018) Prioritizing the integration of geriatric oncology and palliative care Journal of Geriatric Oncology
  • Nicholson, C and Richardson, H (2018) Age-attuned Hospice Care; an opportunity to better end of life care for older people. St Christopher's Hospice
  • Pask, S., Pinto, C., Bristowe, K., Van Vliet, L., Nicholson, C., Evans, C. J., George, R., Bailey, K., Davies, J. M., Guo, P., Daveson, B. A., Higginson, I. J. & Murtagh, F. E (2018). A framework for complexity in palliative care: A qualitative study with patients, family carers and professionals, Palliative Medicine. Published Online 28.2.18.
  • Sarre, S., Maben, J., Aldus, C., Schneider, J., Wharrad, H., Nicholson, C. & Arthur, A. (2017). The challenges of training, support and assessment of healthcare support workers: A qualitative study of experiences in three English acute hospitals International Journal of Nursing Studies. 79, p.145-153
  • Martin J, Nicholson, C and George, R. (2017). The approach of dying and death, and the mourning process of the survivors. Chapter 28 in Oxford Textbook of Geriatric Medicine Third Edition, Michel, J.P; Beattie, L.B.; Martin, F.C.& Walston,J .D (eds) Oxford University Press
  • Combes, S., Nicholson, C., Gillett, K. & Norton, C. (2017). UK: BMJ and BMJ Publishing, Conversations on living and dying: Facilitating advance care planning for older people with frailty Vol. 7. BMJ Supportive & Palliative Care. p. A16 C.
  • Nicholson, C., Gordon, A.l. & Tinker, (2017). ‘Changing the way “we” view and talk about frailty’ Age and Aging, 46, 3, p.349-351
  • Nicholson, C., Morrow, E.M., Hicks, A. & Fitzpatrick, J. (2017). ‘Supportive care for older people with frailty in hospital: An integrative review’ International Journal of Nursing Studies. 66, p.160-71
  • Elliott, M. & Nicholson, C. (2017). ‘A qualitative study exploring use of the surprise question in the care of older people: perceptions of General Practitioners and challenges for practice’ BMJ Palliative and Supportive Care Journal. 7, 1, p. 32-38
  • Antony A Aldus, S Sarre, J Maben, H. Wharrad, J. Schneider, G. Barton, E. Argyle, A. Clark, F. Nouri, C. Nicholson, C. (2017). Can Healthcare Assistant Training improve the relational care of older people? (CHAT) A development and feasibility study of a complex intervention NIHR HSD&R, 5 (10)
  • Nicholson, C., Maben, J. & Ream, E, (2016). 'Partnership between healthcare staff and carers on wards' BMJ, 351, h6933
  • Arthur, A., Maben, J., Wharrad, H., Aldus, C., Sarre, S., Schneider, J., Nicholson, C., Barton, G., Cox, K. & Clark, A. (2015). A. ‘Can Healthcare Assistant Training (CHAT) improve the relational care of older people? Study protocol for a pilot cluster randomised controlled trial’ Trials, 16, 559
  • Nicolson, C. (2016). ‘Developing a clinical research career’, Nursing Times, 112, 24, p.16-18
  • Amador, S., Goodman, C., Mathie, E. & Nicholson, C. (2016). 'Evaluation of an organisational intervention to promote integrated working between health services and care homes in the delivery of end-of-life care for people with dementia: Understanding the change process using a social identity approach', International Journal of Integrated Care, 16, 2, p.14
  • Nicholson, C. (2016). 'How do we facilitate carers' involvement in decision making?' Nursing Older People, 28, 3, p.14
  • Nicholson, C. (2016). ‘Involving carers and families in the care of their loved ones’ Nursing Older People, 28, 3, p.14
  • Nicholson, C. (2016). ‘Collaboration between relatives of elderly patients and nurses and its relation to satisfaction with the hospital care trajectory’ Nursing Older People, 28, 3, p.14
  • Morrow, E.M. & Nicolson, C. (2016). 'Carer engagement in the hospital care of older people: An integrative literature review'. International Journal of Older People Nursing. page 298-314
  • Whittaker, K.A., Maben, J.E., Cowley, S.A., Nicholson, C.J., Malone, M.E. & Grigulis, A.I. (2015) ‘Making a difference for children and families. An appreciative inquiry of health visitor aspirations, values and beliefs and why they start and stay in post’ Health & Social Care in the Community 10.111
  • Policy+ (KCL, NNRU) May 2011- 2014 ( co-editor) Ball, J and Nicholson, C
  • Bridges, J., Nicholson, C., Maben, J., Pope, C., Flatley, M., Wilkinson, C., Meyer J. & Tziggili, M. ‘Capacity for care: meta-ethnography of acute care nurses’ experiences of the nurse-patient relationship’ Chapter in: Patient- centred healthcare: Achieving co-ordination, communication and innovation, 2014, Palgrave Macmillan
  • Nicholson, C., Meyer, J., Flatley, M., Holman, C. (2013). ‘The experience of living at home with frailty in old age: A psychosocial qualitative study’. International Journal of Nursing Studies, 50, p.1172-1179
  • Bridges, J., Nicholson, C., Maben, J., Pope, C., Flatley, M., Wilkinson, C., Meyer J. & Tziggili, M. (2013) ‘Capacity for care: meta-ethnography of acute care nurses’ experiences of the nurse-patient relationship’. Journal of Advanced Nursing, 69, 4, p.760-772
  • Nicholson, C. & Barnes, J. (2013). ‘Appreciative Inquiry’, Chapter 6 in: Participatory Research in Palliative Care: Actions and Reflections, Hockley, J. Froggatt, K. & Heimerl, K. (eds) OUP
  • Rodriguez-Manas, L., Feart, C., Mann, G.E., Vina, J., Somnath, C.J., Chodzko-Zajko, W., Gonzalez-Colaco Harmand, M., Bergman, H., Carcaillon, L., Nicholson, C., Scuteri, A., Sinclair, A., Pelaez, M., Van der Cammen T., Beland, F., Bickenbach, J., Delamarche, P., Ferrucci, L., Fried, P., Gutierrez-Robledo, L.M., Rockwood, K., Rodriguez Artalejo, F., Serviddio, G., VegaE. (2012) ‘Searching for an Operational Definition of Frailty: A Delphi Method Based Consensus Statement. The Frailty Operative Definition-Consensus Conference Project’. Journals of Gerontology Series: A, Biological Sciences and Medical Sciences, 68, 1, p.62-67
  • Nicholson, C., Meyer, J., Flatley, M., Holman, C., Lowton, K. (2012). ‘Living on the margin: understanding the experience of living and dying with frailty in old age’ Social Science and Medicine, 75, 8, p.1426-1432
  • Nicholson, C.J. & Hockley, J. (2011). ‘Death and Dying in Older People’, Chapter 9 in: Death, Dying and Social Differences – 2nd Edition OUP
  • Nicholson, C., Dale, P., Flatley, M., Meyer, J., Wessel, L. & Wilkinson, C. (2010). ‘Everybody matters 3: engaging patients and relatives in decision making to promote dignity’ Nursing Times, 106, 22
  • Nicholson, C., Dale, P., Flatley, M., Meyer, J., Wessel, L. & Wilkinson, C. (2010) ‘Everybody matters 2: promoting dignity in acute care through effective communication’ Nursing Times, 106, 21
  • Nicholson, C., Dale, P., Flatley, M., Meyer, J., Wessel, L. & Wilkinson, C. (2010). ‘Everybody matters 1: how getting to know your patients helps to promote care’ Nursing Times, 106
  • Nicholson, C. and Flatley, M. Everybody Matters; the Dignity in Care Project. Unpublished Report. Royal Free Hospital /City University. London
  • Nicholson, C. (2009) Researcher emotions: a way into the experiences of frail older people’ Journal of Social Work Practice, 23, 4, p.451-459
  • Bridges, J., Flatley, M., Meyer, J. & Nicholson, C. (2009). ‘Best Practice for Older People in Acute Care Settings (BPOP): Guidance for Nurses’ Nursing Standard, 24, 7
  • Bridges, J. & Nicholson, C. (2008) ‘Service improvement using patient narratives: engaging with the issues’ International Journal of Older People Nursing, 3, 3, p. 217-222
  • Nicholson, C. (2007). End-of-Life Care. In My Home Life. Quality of Care in Care Homes, National Care Home Research and Development Forum, Chapter 9, p.118-128, HTA London
  • Meyer, J., Heath, H., Holman, C., Owen, T., Bridges, J., Wilson- Brown, C., Dewar, B., Dudman, J., Davies, S., Nicholson, C., O' May, F. and Reed, J. (2006) ‘Moving from victim blaming to an appreciative inquiry: exploring quality of life in care homes’ Quality in Ageing, 7, 4, p.27-36
  • Nicholson, C & Wells, M. (2003). ‘After Treatment is Over’ Chapter 4 in: Supportive Care in Radiotherapy, Faithfull, S and Wells, M(eds)  Churchill Livingstone



S. N. Etkind, N. Lovell, A. E. Bone, P. Guo, C. Nicholson, F. E. M. Murtagh & I. J. Higginson (2020). The stability of care preferences following acute illness: a mixed methods prospective cohort study of frail older people
View abstract View full publication
: Patient preferences are integral to person-centred care, but preference stability is poorly understood in older people, who may experience fluctuant illness trajectories with episodes of acute illness. We aimed to describe, and explore influences on the stability of care preferences in frail older people following recent acute illness. : Mixed-methods prospective cohort study with dominant qualitative component, parallel data collection and six-month follow up. Study population: age ≥ 65, Rockwood Clinical Frailty score ≥ 5, recent acute illness requiring acute assessment/hospitalisation. Participants rated the importance of six preferences (to extend life, improve quality of life, remain independent, be comfortable, support ‘those close to me’, and stay out of hospital) at baseline, 12 and 24 weeks using a 0–4 scale, and ranked the most important. A maximum-variation sub-sample additionally contributed serial in-depth qualitative interviews. We described preference stability using frequencies and proportions, and undertook thematic analysis to explore influences on preference stability. : 90/192 (45%) of potential participants consented. 82/90 (91%) answered the baseline questionnaire; median age 84, 63% female. Seventeen undertook qualitative interviews. Most participants consistently rated five of the six preferences as important (range 68–89%). ‘Extend life’ was rated important by fewer participants (32–43%). Importance ratings were stable in 61–86% of cases. The preference ranked most important was unstable in 82% of participants. Preference stability was supported by five influences: the presence of family support; both positive or negative care experiences; preferences being concordant with underlying values; where there was slowness of recovery from illness; and when preferences linked to long term goals. Preference change was related to changes in health awareness, or life events; if preferences were specific to a particular context, or multiple concurrent preferences existed, these were also more liable to change. : Preferences were largely stable following acute illness. Stability was reinforced by care experiences and the presence of family support. Where preferences were unstable, this usually related to changing health awareness. Consideration of these influences during preference elicitation or advance care planning will support delivery of responsive care to meet preferences. Obtaining longer-term data across diverse ethnic groups is needed in future research.