What Is Palliative Care? Why It's Not Just for the End of Life
For many people, the words palliative care land like a full stop. They sound like the moment doctors stop trying. In reality, palliative care is something quite different: an extra layer of support focused on how you feel and how you live, which can start at diagnosis and run alongside other treatment. Understanding what it is, and what it is not, can make a hard time a little easier for you or someone you love.
What Palliative Care Actually Is
Palliative care is an approach that improves quality of life for people facing a serious, life-threatening illness, and for their families. It focuses on relieving suffering of every kind: physical symptoms such as pain, breathlessness, nausea and fatigue, but also emotional, social and spiritual concerns.
It is delivered by a team. That might include specialist doctors and nurses, your GP or family doctor, social workers, counsellors, physiotherapists and chaplains. Care can happen at home, in hospital, in a care home or in a hospice.
Palliative care intends neither to hasten nor to postpone death. Its goal is comfort, dignity and the best possible quality of life for as long as life lasts.
Palliative Care and Hospice: What's the Difference?
The two terms are often used as if they mean the same thing, but they do not.
Palliative care can begin at any stage of a serious illness, including right at diagnosis. You can receive it at the same time as treatments aimed at controlling or curing the illness, such as chemotherapy, dialysis or heart medication.
Hospice care, sometimes called end-of-life care, is a form of palliative care for people who are likely to be in the last months of life. In the US, for example, hospice eligibility under Medicare generally applies when a doctor expects a life expectancy of six months or less, and usually means moving away from treatments aimed at cure. In the UK, Canada and across Europe, the word hospice can also describe a place, and many hospices support people at home too.
Put simply: all hospice care is palliative care, but not all palliative care is hospice care.
It is estimated that only about 14% of people worldwide who need palliative care actually receive it. Knowing it exists, and that you can ask for it, is often the first step.
Common Myths, Gently Corrected
Myth: it means giving up. Palliative care is about adding support, not taking treatment away. Many people move in and out of palliative care services as their needs change.
Myth: it is only for cancer. Palliative care can help people living with heart failure, lung disease such as COPD, kidney disease, dementia, motor neurone disease (ALS), Parkinson's and many other conditions.
Myth: it is only for the patient. Supporting family members and carers is part of the definition, including practical help, emotional support and bereavement care.
Myth: strong pain relief shortens life. This is a very common fear. Reviews of the evidence have found that when pain medicines such as morphine are carefully prescribed and adjusted by specialists, they have not been shown to shorten life. If this worry is on your mind, it is a good question to raise directly with the care team.
What the Research Says, and How to Ask for It
One of the best-known studies, published in the New England Journal of Medicine in 2010, followed people with advanced lung cancer. Those who received palliative care early, alongside their usual cancer treatment, reported better quality of life and fewer symptoms of depression than those who received usual care alone. A larger review in JAMA in 2016, pooling results across many trials, found palliative care was associated with improvements in quality of life and symptom burden.
Despite this, many people who could benefit never receive it. The WHO estimates that only about 14% of people worldwide who need palliative care currently receive it.
If you or someone close to you is living with a serious illness, you do not need to wait to be offered it. You can ask. Useful questions include: Could palliative care help with my symptoms now? Can I have it alongside my current treatment? Who would be part of the team, and where would care happen?
Asking questions like these is part of understanding your care and agreeing to it. If you would like more help preparing for that kind of conversation, our guide Informed Consent: Your Right to Ask Questions About Any Treatment sets out simple questions you can take to any appointment.
It is also worth thinking about advance care planning: talking with your loved ones and care team about what matters most to you, and recording your wishes, so that decisions later reflect your values. Every country has its own forms and processes, and your doctor can point you to them.
Trusted starting points include Marie Curie and Hospice UK in the UK, the Center to Advance Palliative Care (getpalliativecare.org) in the US, the Canadian Hospice Palliative Care Association in Canada, and the European Association for Palliative Care across Europe.
Palliative care is, at its heart, about living as well as possible. It is about being heard, being comfortable, and having support around you and the people you love. If serious illness has touched your family, you are allowed to ask for that support, early and often. It is not giving up. It is making sure that, whatever lies ahead, the focus stays on you as a whole person.
- World Health Organization, 2020. Palliative care: key facts (fact sheet). Geneva: WHO. https://www.who.int/news-room/fact-sheets/detail/palliative-care
- Temel, J.S., Greer, J.A., Muzikansky, A. et al., 2010. Early palliative care for patients with metastatic non-small-cell lung cancer. New England Journal of Medicine, 363(8), 733–742. doi:10.1056/NEJMoa1000678
- Kavalieratos, D., Corbelli, J., Zhang, D. et al., 2016. Association between palliative care and patient and caregiver outcomes: a systematic review and meta-analysis. JAMA, 316(20), 2104–2114. doi:10.1001/jama.2016.16840
- Sykes, N. and Thorns, A., 2003. The use of opioids and sedatives at the end of life. The Lancet Oncology, 4(5), 312–318. doi:10.1016/S1470-2045(03)01079-9
- Sudore, R.L., Lum, H.D., You, J.J. et al., 2017. Defining advance care planning for adults: a consensus definition from a multidisciplinary Delphi panel. Journal of Pain and Symptom Management, 53(5), 821–832. doi:10.1016/j.jpainsymman.2016.12.331
- Centers for Medicare & Medicaid Services. Medicare hospice benefits. https://www.medicare.gov/coverage/hospice-care
This article is intended for informational and educational purposes only and is not medical advice. Palliative care services, eligibility and paperwork differ between countries. If you or someone you love is living with a serious illness, please speak to your doctor or care team about the support available.