Palliative care and end-of-life care: what is the difference?

Palliative care and end-of-life care are closely connected, but they describe different parts of a person’s support. Palliative care focuses on comfort and quality of life during a serious or life-limiting illness. End-of-life care focuses more specifically on support and planning as a person approaches the end of life. They are not competing choices, and a person may receive both.

What palliative care means

Palliative care is an approach to supporting someone who is living with a serious or life-limiting illness. Its purpose is to help the person have the best possible quality of life, while also recognising the effect of illness on family members and other people close to them. It considers the whole person, not just one part of their health.

Conversations about palliative care can include comfort, daily life, emotional wellbeing, relationships, communication, culture, faith and personal priorities. The kind of support involved depends on the person’s circumstances. It may be coordinated by different healthcare professionals and can take place in more than one setting over time.

Palliative care may be provided alongside other treatment. It does not automatically mean that all other treatment has stopped, nor does it tell a family exactly how long someone has left. The focus is on understanding what matters to the person and ensuring that their support is reviewed as their needs and wishes change.

For families, the phrase can sometimes feel worrying or unfamiliar. Asking what palliative care means in the particular situation can make the conversation clearer. It is reasonable to ask who is involved, what each person’s role is, how information will be shared and how the person’s wishes will be included.

What end-of-life care means

End-of-life care is the support and planning provided as someone approaches the end of life. It aims to protect comfort, dignity and the person’s individual wishes, while helping the people important to them understand what is happening. The conversation may begin before the final days of life, because needs and decisions can change over time.

End-of-life care can involve personal care, nursing assessment and monitoring, emotional and spiritual support, family communication, individual care planning and coordination with relevant healthcare professionals. It may also involve talking about the person’s priorities for future care and who they would like involved in decisions or updates.

There is no single end-of-life care plan that is right for everyone. A plan should reflect the person’s wishes as far as possible, while remaining responsive to their current circumstances. It should be revisited when there is a significant change, and families should be given opportunities to ask questions and share information that may help the team understand the person.

The term does not describe one particular place. End-of-life care may be discussed in relation to home, hospital, a hospice or a nursing home, depending on the person’s needs, wishes, available support and professional advice. Each setting has a different role, and the right option can change.

What the two approaches have in common

Both palliative care and end-of-life care should be person-centred. They begin with listening to the person, understanding their priorities and considering the people who matter to them. Comfort and dignity are important, as are clear communication and care that respects the person’s culture, beliefs and everyday routines.

Both approaches can include support for family members. Relatives may need information about changes, opportunities to ask questions and help understanding who to contact. The person’s consent, confidentiality and ability to make decisions should be respected, with family involvement considered in the appropriate way.

Both approaches also depend on communication between the people involved. A person’s support may involve a nursing team, other healthcare professionals, family members and the person themselves. Keeping the plan clear and reviewing it as circumstances change can help everyone work from the same understanding.

The most useful question is often not which label applies, but what support the person needs now, what matters to them and what may need to be discussed next. Families can ask professionals to explain unfamiliar terms in plain language and to say what is known, what is uncertain and when the plan will be reviewed.

Questions families may want to ask

Families do not need to ask everything at once. A short list can make a conversation easier, especially after a hospital admission or a change in health. Non-clinical questions may include:

• What matters most to the person, and how will their wishes be recorded?
• Who is involved in the person’s care and who should the family contact with questions?
• Who has the person said they would like involved in conversations and updates?
• How will information be shared if the person’s needs or setting changes?
• What support is available for the person’s emotional, cultural or spiritual needs?
• What should the family bring or prepare before the next discussion?
• When will the care plan be reviewed, and who will take part?
• What options should the family understand if the current support is no longer suitable?

These questions are intended to support communication, not to replace professional assessment. A family can ask for time to think, request that information is written down, or ask for a further conversation if they are unsure about what they have heard.

Support at Wyndley Grange

Wyndley Grange is a nurse-led care home in Sutton Coldfield and provides 24-hour nursing support. It is one possible nursing-home setting for a person whose needs can be safely met there; it is not a hospice, hospital or home-care service.

The team can discuss whether the home may be able to meet a relative’s needs after an individual assessment and subject to current availability. Admission, transfer or a particular outcome cannot be promised in advance. An assessment allows the team to understand the person’s needs, wishes and current circumstances before discussing whether the home may be suitable.

Families can learn more through the guide to understanding end-of-life care, the page on planning ahead and the information about support for families. To compare settings, read end-of-life care options. You can also read the FAQs, learn about Wyndley Grange or contact the home.