Objectives: Elucidate recognition of end-of-life care by nursing care staff in elderly care facilities, and factors influencing such recognition. Methods: We conducted an internet questionnaire with 500 nursing care staff working at elderly care facilities across Japan, and an interview with 10 nursing care staff out of 500. Results: In the questionnaire, facility policies (41%) and cooperation with medical staff (38%) were selected as facilities and systems that are important for end-of-life care, and as a concern, sudden change in the condition of the patient, leading to death (53%) was selected. The interview showed that nursing care staff had a certain level of anxiety regardless of their experience with end-of-life care, with participants discussing their thoughts on how systematic learning of, and actual experience in, end-of-life care changed end-of-life care. Conclusion: Our study showed that systematic learning and experience of end-of-life care were important factors in recognition of end-of-life care by nursing care staff when providing such care in elderly care facilities.