Improvements need to be made to the way in which 40% of Scottish care homes offer end-of-life support, a watchdog has said.
Inspectors for the Care Commission found 449 of homes they visited were unaware residents with life-limiting illnesses should be given such care.
During three investigations, 1,036 inspections were carried out between April 2007 and March 2008 to compile a report.
The Better Care Every Step of the Way report also found more than half of the homes were unable to train their staff about how to approach sensitive issues.
The commission said: "Staff members found it hard to talk to residents and their relatives and carers about how living with a life-limiting illness affected them."
The report made 546 recommendations for improvement in specific care homes, including calls for better training overall.
Susan Brimelow from the commission, said: "It's disappointing that the palliative care needs of residents in 43% of care homes in Scotland are not always recognised or well supported by staff.
"Care home providers and managers must recognise the need for increased knowledge, skills and educational support to ensure residents, families and carers receive high-quality palliative and end-of-life care."