Introduction:
Nursing education curricula often lack adequate preparation for providing optimal care to elderly patients facing end-of-life situations in long-term care homes. This gap leaves nursing students ill-equipped to support patients and their families during this critical time. Innovative educational resources focusing on end-of-life care for the elderly in long-term care settings are needed to address this issue.

Methods:
This study presents an open-access Virtual Serious Game (VSG) designed for nursing students and professionals to enhance their skills in providing end-of-life care for the elderly in long-term care homes. The development process involved gathering feedback from nurses with expertise in end-of-life care in long-term care settings through a survey, which informed the VSG design. The VSG was then tested for usability with nursing students and evaluated for its alignment with intended goals.

Findings:
Survey responses revealed six themes that guided the VSG's design and educational objectives. These themes emphasized the importance of skills assessment, medication management, identifying end-of-life signs, improving communication and empathy, and promoting teamwork and ethical decision-making in the context of caring for elderly patients in long-term care homes. After several iterations of user testing and enhancements, the VSG achieved a System Usability Scale (SUS) score of 87, with players completing the game within an average of six minutes.

Conclusion:
The VSG serves as an open-access educational tool tailored for nursing students, providing a platform to enhance their skills and understanding in delivering high-quality end-of-life care for the elderly in long-term care homes. Future research will evaluate the VSG's impact on learning outcomes and its potential integration into nursing education programs, with a focus on improving end-of-life care for elderly patients in long-term care settings.

Keywords: Virtual serious game, end-of-life care, elderly, long-term care homes, nursing education.