Palliative care and end of life care are closely related, but they are not exactly the same thing. People often hear both terms when someone has a serious or incurable illness, and it is understandable to be unsure about what each one means.
This guide explains the difference in plain English, using current NHS guidance. It is written for patients, relatives and carers who want to understand what support may be available and what the terminology actually means.
Palliative care vs end of life care: the simple difference
The simplest way to understand it is this:
- Palliative care can begin much earlier in a serious or life-limiting illness. It focuses on comfort, symptom control and quality of life, and it can be given at the same time as treatment for the illness.
- End of life care is a form of palliative care for people who are approaching the end of their life. NHS guidance generally uses this term for people who may be in the last 12 months of life, although predicting this exactly is not always possible.
So, all end of life care is palliative care, but not all palliative care is end of life care.
What is palliative care?
Palliative care is care for people living with an illness that cannot be cured or is life-limiting. Its aim is to help the person live as well and as comfortably as possible.
According to the NHS, palliative care may include:
- relief from pain and other distressing symptoms
- help with breathlessness, nausea, fatigue or other physical problems
- psychological and emotional support
- social and practical support
- spiritual or religious support where this matters to the person
- support for family members and carers
This is often described as a holistic approach because the care looks at the whole person rather than only the illness.
Does palliative care mean someone is dying?
No. This is one of the most common misunderstandings.
Someone can receive palliative care for months or years, depending on their illness and needs. Palliative care can also be provided while the person is still receiving treatment intended to slow the illness, control it or help them live longer.
Being referred to palliative care does not necessarily mean that treatment has stopped, and it does not automatically mean that death is expected soon.
What is end of life care?
End of life care is support for people who are approaching the end of their life. NHS guidance says this may include people who are likely to die within the next 12 months, although it can be difficult to predict exactly how long someone has left.
End of life care is intended to help a person:
- live as well as possible for the time they have
- remain as comfortable as possible
- have pain and other symptoms managed
- be involved in decisions about their care
- express where they would prefer to be cared for
- have their wishes, beliefs and priorities respected
- receive care with dignity
It should also include support for the people close to them.
What is the difference between palliative care and end of life care?
| Palliative care | End of life care |
|---|---|
| Can begin earlier in a serious or incurable illness | Usually refers to care during the last phase of life |
| May continue for months or years | May last days, weeks, months or sometimes longer |
| Can be given alongside treatments for the illness | Focuses particularly on comfort, dignity, wishes and priorities as life draws to a close |
| Supports physical, psychological, social and spiritual needs | Also supports physical, psychological, social and spiritual needs |
| Does not mean death is necessarily close | Means the healthcare team believes the person may be approaching the end of life |
When does palliative care start?
Palliative care can begin when a person is diagnosed with a life-limiting or incurable condition and has symptoms or other needs that would benefit from additional support.
It is not limited to cancer. People living with conditions such as advanced heart failure, lung disease, dementia, motor neurone disease and other progressive illnesses may also receive palliative care.
The right time to involve palliative care depends on the individual. If symptoms are difficult to control, or the person or family needs more support, it is reasonable to ask the GP, hospital team or community team whether palliative care would help.
When does end of life care start?
There is no single moment when palliative care suddenly becomes end of life care.
A healthcare team may begin talking about end of life care when they believe a person may be entering the last year of life, or when their condition is changing and their needs are becoming more focused on comfort, planning and personal wishes.
For some people this period lasts many months. For others, deterioration happens much more quickly.
If you are trying to understand the changes that may happen in the final weeks, days or hours, you may also find our guide What to Expect When Someone Is Dying helpful.
Who provides palliative and end of life care?
Care can involve a number of different professionals depending on the person’s needs and where they are being cared for.
This may include:
- GPs
- district or community nurses
- hospital doctors and nurses
- hospice staff
- specialist palliative care doctors and nurses
- care home staff
- social care teams
- physiotherapists and occupational therapists
- counsellors, chaplains or other emotional and spiritual support
Not everybody needs a specialist palliative care team. Many people receive good palliative care from their usual GP, community or hospital team, with specialist support added if their needs become more complex.
Where can palliative or end of life care be provided?
Depending on the person’s needs, wishes and available services, care may be provided:
- at home
- in a care home or nursing home
- in hospital
- in a hospice
- in some community healthcare settings
Where possible, the person’s preferences should be discussed and taken into account when their care is planned.
Is a hospice only for the final days of life?
No. Hospice care is another area that is often misunderstood.
Hospices can provide symptom control, outpatient support, day services, community care, respite care and support for relatives as well as care for people who are dying. Some people are admitted to a hospice for a short period to help bring difficult symptoms under control and later return home.
Can someone still have treatment while receiving palliative care?
Yes. Palliative care can be provided alongside other treatment.
For example, someone may receive medication, chemotherapy, radiotherapy, oxygen therapy or other treatments while also receiving palliative care to help manage symptoms and improve their quality of life.
The exact treatment plan depends on the person’s condition, goals and clinical circumstances and should be discussed with their healthcare team.
What does “comfort care” mean?
People sometimes use the phrase comfort care when the priority has shifted towards controlling symptoms and keeping the person comfortable.
It can include pain relief, treatment for breathlessness, anxiety or agitation, mouth care, positioning, skin care and emotional support. The exact meaning can vary, so if a healthcare professional uses the term and you are unsure what it means for your relative, ask them to explain.
Does end of life care mean treatment stops?
Not necessarily. End of life care does not mean that a person is simply left without treatment.
Treatment may continue when it is helping the person feel better, relieving symptoms or meeting their wishes. At the same time, treatments that are no longer helping, or that may cause more burden than benefit, may be reviewed by the healthcare team with the person and those involved in their care.
What questions can families ask the healthcare team?
If you are unsure what stage your loved one is at, it is reasonable to ask clear questions. For example:
- Are we talking about palliative care or end of life care?
- What changes are you seeing in their condition?
- What symptoms should we look out for?
- Who should we call if they become uncomfortable or distressed?
- Who do we contact overnight or at weekends?
- Can they be cared for at home if that is what they want?
- Should we discuss advance care planning?
- What support is available for family members or carers?
You do not have to understand medical terminology before asking these questions. Healthcare professionals should explain what is happening in language that makes sense to you.
If someone is approaching the end of life
If the healthcare team has explained that someone is likely to be approaching the end of their life, it can help to understand the practical arrangements as well as the medical care.
Our guide What To Do When Someone Dies explains what normally happens after an expected death at home, in hospital or in a care setting, including verification, the medical examiner process and registering the death.
If you are considering a simple cremation afterwards, you can also read about direct cremation in Kent, including what it involves and how BM cares for someone after they are entrusted to us.
Planning ahead does not mean giving up
Families sometimes worry that discussing end of life care, funeral arrangements or what happens after death means they are giving up on the person.
It does not. Planning can help ensure that the person’s wishes are understood and can reduce uncertainty for relatives later.
You do not need to arrange everything in advance. Even knowing who to call and what is likely to happen can make a difficult situation feel a little more manageable.
Sources and further information
This article has been written using current information from trusted UK health organisations. For further information, see:
- NHS: What end of life care involves
- NHS England: Palliative and end of life care
- Marie Curie: End of life care
This article provides general information and is not medical advice. If you are concerned about someone’s health, symptoms or care, speak to their GP, hospital team, community nurse or palliative care team. Use NHS 111 for urgent advice when appropriate and call 999 in an emergency.
Need help understanding what happens after death?
BM Funeral Service provides professional deceased care and direct cremation from our base in Charing, Kent. You are welcome to contact BM Funeral Service before a death if you simply want to understand the practical next steps.