Palliative and End of Life Care: Facts and Guidance
Author: Disabled World (DW)
Updated/Revised Date: 3 Nov 2026
Table of Contents:
Synopsis - Definition - About This Section - FAQs - Publications - Subtopics
Synopsis
Understand palliative care and end of life care, how they differ, the goals of each, hospice eligibility, and what matters most in end of life discussions.
At a Glance
- 1 - Roughly one-quarter of traditional Medicare spending goes to care in the last year of life.
- 2 - Palliative care can be given at any stage of a serious illness, not only near the end of life.
- 3 - In the United States, hospice care applies when a patient has a prognosis of six months or less to live.
- 4 - In a 2014 Canadian study, patients reported that on average only 1.4 of 11 key end of life elements were discussed.
Topic Definition
- Palliative Care and End of Life Care
Palliative care is a specialized area of health care focused on relieving and preventing suffering for people living with a serious, life-limiting, or life-threatening illness, along with support for their families. Rather than being limited to a person's final days, it can begin at any stage of an illness and may be given alongside treatments intended to cure or prolong life, addressing physical symptoms such as pain as well as psychological, social, and spiritual needs through a multidisciplinary team. End of life care is a component within this broader approach, referring specifically to the care of people whose terminal condition has become advanced, progressive, and incurable, typically in the last months of life. Together these approaches aim to improve quality of life, respect patient wishes and autonomy, and support both the individual and their loved ones through illness and bereavement.
Overview
Everyone dies eventually, but the way people die has changed. Before antibiotics and other medical advances, many people died quickly from infections or accidents. Today, many people live for months or years with a serious illness, and patients and their families have a broad range of physical, psychological, social, spiritual, and practical needs.
Attention to quality of life for people with serious illness has grown greatly in recent decades, and palliative care teams are now part of many hospitals. A palliative care team is a group of health professionals who work together to relieve symptoms and stress and to support patients and families, alongside the patient's other care.
What is the Difference Between Palliative Care and End of Life Care?
End-of-life care is care in the last part of a person's life, typically the last few months, depending on the illness and how it progresses, and it also includes planning for that care. Palliative care includes end-of-life care, but it is much broader.
Palliative care focuses on improving the quality of life and quality of care for patients with a life-threatening or life-limiting illness, and for their families. It does this through the prevention and relief of suffering, communication about goals of care, and the early identification, assessment, and treatment of pain and other physical, psychosocial, and spiritual problems.
Both palliative care and end of life care are defined in more detail below.
Palliative Care
Definition: An approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness, through the prevention and relief of suffering by means of early identification and careful assessment and treatment of pain and other problems, physical, psychosocial, and spiritual.
Hospice care, care at the end of life, always includes palliative care, but palliative care can be given at any stage of an illness. Its goal is to make the person comfortable and improve their quality of life. Doctors sometimes use the term palliative care to mean treatment without curative intent, when no cure can be expected, as often happens in late-stage cancers. The term is also used more and more for illnesses other than cancer, such as chronic lung disease, kidney disease, chronic heart failure, HIV/AIDS, and progressive neurological conditions.
In the United States, hospice services and palliative care programs share the goals of symptom relief and pain management. Non-hospice palliative care is appropriate for anyone with a serious, complex illness, whether they are expected to recover fully, to live with a chronic illness for a long time, or to experience disease progression. Hospice care is also palliative, but the term hospice applies to care for patients with a prognosis of 6 months or less to live.
Palliative medicine uses a multidisciplinary approach, relying on physicians, nurses, chaplains, social workers, psychologists, and other allied health professionals to build a plan of care that relieves suffering in all areas of a patient's life. Its goals are concrete: relief from suffering, treatment of pain and other distressing symptoms, psychological and spiritual care, support to help the person live as actively as possible, and support to help the family cope and recover.
Palliative care:
- Intends neither to hasten nor to postpone death
- Affirms life and regards dying as a normal process
- Provides relief from pain and other distressing symptoms
- Integrates the psychological and spiritual aspects of patient care
- Offers a support system to help patients live as actively as possible until death
- Enhances quality of life, and may also positively influence the course of illness
- Offers a support system to help the family cope during the patient's illness and in their bereavement
- Uses a team approach to address the needs of patients and their families, including bereavement counseling if needed
- Can be given early in an illness, together with treatments meant to prolong life, such as chemotherapy or radiation therapy, and includes the investigations needed to understand and manage distressing complications
End of Life Care
Definition: In medicine, nursing, and the allied health professions, end-of-life care refers to health care not only of patients in the final hours or days of their lives, but more broadly of all people with a terminal illness or condition that has become advanced, progressive, and incurable.
End-of-life care involves many decisions, including questions of palliative care, the patient's right to self-determination, the ethics and usefulness of extraordinary or risky medical treatments, and even the ethics and usefulness of continuing routine medical treatments. It also touches on how hospitals and national health systems use their resources. Such decisions are shaped by medical considerations, economic factors, bioethics, and respect for patient autonomy.
In the United States, roughly one-quarter of traditional Medicare spending on health care goes to services for beneficiaries in their last year of life, a share that has stayed about the same for decades [KFF, 2016]. Much of this reflects the high cost of caring for people who are very ill, and many Americans spend their last days in an intensive care unit. Talking early about goals of care helps make sure that treatment matches what the person wants.
End of Life Discussions
What are the most important things for health care teams to talk about with patients in hospital and their families near the end of life? A 2014 study published in CMAJ (Canadian Medical Association Journal) asked older patients and their families about their top priorities and found gaps between what patients wanted and the care they received [You et al., 2014]. "Our findings could be used to identify critical opportunities to improve end-of-life communication and decision-making in the hospital setting," said Dr. John You, the lead author, then an associate professor at McMaster University and a staff physician at Hamilton Health Sciences in Hamilton, Ontario.
Guidelines at the time listed 11 key elements for health care providers to discuss about end-of-life care, based mainly on expert opinion rather than on patient and family feedback. The researchers surveyed 233 older adults in hospital with serious illnesses and 205 family members about the importance of these 11 elements. The patients had been admitted to 9 hospitals in British Columbia, Alberta, Ontario, and Quebec.
The elements patients and families rated as most important were:
- Preferences for care if the illness becomes life-threatening
- Patient values
- Prognosis of the illness
- Fears or concerns
- Additional questions about care
"However, we found that these elements are infrequently discussed and that concordance between preferred and prescribed goals of care is low," the authors wrote. Patients reported that, on average, only 1.4 of the 11 elements had been discussed with the health care team in the first few days after admission. The more elements were discussed, the more satisfied patients and families were with their care, and the authors hoped their findings would help improve end-of-life care in hospitals.
Frequently Asked Questions
Does palliative care mean giving up on treatment?
No, palliative care can be provided alongside treatments meant to cure or control an illness, and its focus on comfort and quality of life does not require stopping other care.
Who provides palliative care?
Palliative care is delivered by a multidisciplinary team that may include physicians, nurses, social workers, chaplains, psychologists, and other allied health professionals working together on a plan of care.
Where can palliative and end of life care be provided?
Care can take place in hospitals, dedicated units, nursing homes, hospice facilities, or a person's own home, depending on their needs, wishes, and available services.
How do you start a conversation about end of life care?
It often helps to raise the topic early and calmly, sharing values and concerns with loved ones and the care team, and asking clear questions about prognosis, options, and preferences.
What is an advance care plan?
An advance care plan is a record of a person's wishes for future medical treatment, helping ensure their preferences are respected if they later become unable to make decisions themselves.
Is palliative care covered by insurance?
Coverage varies by country and plan, but many public and private insurers, including Medicare in the United States, provide some coverage for palliative and hospice services.
What is the difference between hospice and palliative care?
Palliative care is available at any illness stage and alongside curative treatment, while hospice care is a form of palliative care generally reserved for those expected to have six months or less to live.
What is a palliative care team?
A palliative care team usually includes doctors, nurses, social workers, and chaplains who work together on pain and symptom relief, emotional support, and planning. They work alongside the patient's own doctors rather than replacing them.
References
- KFF. (2016). 10 FAQs: Medicare's role in end-of-life care.
- You, J. J., et al. (2014). What really matters in end-of-life discussions? Perspectives of patients in hospital with serious illness and their families. CMAJ, 186(18), E679 - E687.
Curated and edited by Ian C. Langtree, Founder and Editor-in-Chief, Disabled World. This section is maintained by the Disabled World editorial team. Last updated: