Palliative care is specialist support for anyone living with a serious illness that cannot be cured. Its job is to help you live as well as possible by controlling pain and other symptoms and by looking after how you feel, not just your diagnosis. The common assumption that palliative care means you are dying is wrong. The NHS is explicit that “palliative care is available when you first learn you have a life-limiting (terminal) illness”, and some people receive it for years. End of life care is only one part of palliative care, the part you reach when you are close to death. You can start palliative care at diagnosis and keep having treatments aimed at controlling your illness at the same time.
At a glance: Nexis CPD’s £9 Palliative Care course explains what palliative care is, how it differs from end of life care, symptom and comfort support, communication, and the carer’s role. It is CPD accredited and 100% online with a verifiable e-certificate, and any three courses cost £18. It is awareness training, not a clinical or regulated qualification.
What is palliative care?
Palliative care is the care and support given to someone who has a serious, progressive illness that is not going to be cured. The World Health Organization defines it as “an approach that improves the quality of life of patients (adults and children) and their families who are facing problems associated with life-threatening illness”. The key word is quality. Palliative care does not try to speed up or delay death. It tries to make the time a person has as comfortable and as meaningful as possible.
It is often called holistic care, and that word is doing real work. The NHS describes palliative care as “a holistic approach, because it deals with you as a ‘whole’ person, not just your illness or symptoms”. In practice that means four things at once: controlling physical symptoms such as pain, breathlessness, sickness and poor appetite; supporting someone emotionally and psychologically; helping with practical worries such as money, work and who will look after the family; and respecting whatever gives a person meaning, whether that is a faith, a relationship or simply being at home with a pet.
Palliative care is sometimes described as “supportive care”, because it supports a person through an illness rather than curing it. It runs alongside everything else that is happening. Someone having chemotherapy to shrink a tumour, dialysis for failing kidneys, or medication to manage heart failure can have palliative care at the very same time. One treats the disease; the other treats the person.
Is palliative care the same as end of life care?
No, and this is the single most useful thing to understand. The two terms are used as if they mean the same thing, and they do not. End of life care sits inside palliative care, like a smaller circle inside a bigger one.
The NHS puts it simply: “End of life care is a form of palliative care you receive when you’re close to the end of life.” Marie Curie adds that “although it can include end of life care, palliative care is much broader and can last for longer”. Crucially, it says “having palliative care doesn’t necessarily mean that you’re likely to die soon – some people have palliative care for years”.
So the difference is about timing and scope, not about the type of kindness involved:
- Palliative care is the whole journey of living with an incurable illness. It can begin at diagnosis and continue for months or years, often while other treatments carry on.
- End of life care is the care given in the last part of that journey. In the UK this usually refers to the final year of life, and the term is often applied most intensively to the last weeks and days.
Why does the distinction matter so much? Because when people think the two are identical, families sometimes refuse a palliative care referral in a panic, believing it is a death sentence or that doctors have “given up”. They can then miss out on months of symptom control and support that would have made life genuinely better. If you work in care, gently explaining the difference to a worried relative is one of the most valuable conversations you will have. Our guide to end of life care covers the final stage in detail.
When does palliative care start?
Earlier than most people expect. The NHS states that palliative care is available “when you first learn you have a life-limiting (terminal) illness”, and that “you might be able to receive palliative care while you’re still receiving other therapies to treat your condition”. There is no rule that treatment must stop before palliative care begins.
The WHO goes further and says this early start is better medicine, not just kinder: “Palliative care is most effective when considered early in the course of the illness. Early palliative care not only improves quality of life for patients but also reduces unnecessary hospitalisations and use of health-care services.” In other words, getting on top of symptoms and planning early tends to mean fewer crisis admissions to hospital later.
This is also where the national guidance lives. The National Institute for Health and Care Excellence guideline NG142, End of life care for adults: service delivery, published on 16 October 2019, covers care in “the final weeks and months of life (or for some conditions, years)”. That phrase in brackets matters. For slowly progressing conditions such as some neurological diseases, the palliative phase can be measured in years, and services are expected to plan for that.
A practical note for families: you do not usually refer yourself to palliative care. A GP, hospital consultant or specialist nurse makes the referral, and you can always ask them about it. Being referred does not commit you to anything or stop any current treatment.
Who is palliative care for?
Palliative care is for anyone with a serious illness that cannot be cured, at any age. The biggest myth here is that it is only for people with cancer. It is not.
The NHS names cancer, dementia and motor neurone disease as examples, and that short list already stretches well beyond cancer. Globally, the picture is even clearer. The WHO reports that most adults who need palliative care have long-term conditions, and breaks the worldwide need down as cardiovascular diseases (38.5%), cancer (34%), chronic respiratory diseases (10.3%), AIDS (5.7%) and diabetes (4.6%), with many other illnesses adding to the total. Heart failure, advanced lung disease such as COPD, kidney failure, Parkinson’s disease and advanced dementia can all bring a need for palliative care.
The scale of the need is large and poorly met. The WHO estimates that “an estimated 56.8 million people, including 25.7 million in the last year of life, are in need of palliative care” each year, yet “only about 14% of people who need palliative care currently receive it”. The UK does better than the global average but still falls short. Research funded by Marie Curie, led by King’s College London and the University of Hull, estimates that around 170,000 people in England each year die without the care and support they need, with almost one in three dying with unaddressed pain or other symptoms. On current trends that unmet need is projected to rise by around 23% over the next 25 years. The point for anyone working in health or social care is simple: the people in front of you who could benefit from palliative care almost certainly outnumber the people who are getting it.
What does palliative care involve day to day?
It depends entirely on the person, which is the whole idea. But most palliative care covers the same broad areas.
Controlling symptoms. The NHS says palliative care “aims to make you as comfortable as possible by managing your pain and other distressing symptoms”. That includes pain, but also breathlessness, nausea and vomiting, constipation, poor appetite, tiredness and trouble sleeping. Good symptom control is skilled work, and it is the part that most directly changes how a day feels.
Emotional and psychological support. A serious diagnosis brings fear, anger, low mood and anxiety, for the person and for those around them. The NHS describes palliative care as involving “psychological, social and spiritual support for you and your family or carers”. Simply being listened to, without being rushed, is part of the treatment.
Practical and social help. This can mean help claiming benefits, sorting equipment for the home, arranging respite so a family carer can rest, or thinking through care for children or pets. These are not extras. For many families they are the difference between coping and not coping.
Spiritual support. This is not only about religion. It is about what matters to a person and helps them make sense of what is happening. A hospital chaplain, the NHS notes, is there for people “of all faiths or none”.
Alongside this, dignity runs through everything. Preserving someone’s privacy, choices and sense of self when they are ill and dependent is central to good care. Our guides to dignity in care and person-centred care explain how that works in practice.
Who provides palliative care?
Most palliative care is given by ordinary health and social care staff, not by specialists. This is an important and reassuring point. The NHS says “different health and social care professionals may be involved in your end of life care, depending on your needs”, and the list it gives is long: hospital doctors and nurses, GPs, community (district) nurses, hospice staff, counsellors, social care staff, chaplains, physiotherapists, occupational therapists, complementary therapists, and the specialists – palliative medicine consultants and specialist palliative care nurses.
It helps to think of two levels:
- Generalist palliative care is provided by the people already around someone: their GP, district nurses, hospital ward teams and care home or home care staff. For many people this is all the palliative care they will need.
- Specialist palliative care comes from teams with extra training, including palliative medicine consultants, clinical nurse specialists (often the Macmillan or hospice nurses people have heard of) and hospice teams. They are brought in for more complex symptoms or difficult situations, usually working alongside the generalist team rather than replacing it.
Care workers and senior carers sit squarely in that generalist group. You will often be the person who spots that someone is in more pain than usual, eating less, more withdrawn, or frightened in the night. Noticing and reporting those changes early is a genuine clinical contribution, even though it is not a clinical task. Knowing the limits matters too: adjusting medication, giving injections or syringe-driver care are tasks that need specific training and sign-off, not something an awareness course qualifies anyone to do.
Where can you receive palliative care?
In more places than people realise, and increasingly in a person’s own home. Marie Curie lists the settings plainly: “your home, a hospital, a care home or nursing home, a hospice.” Most people, when asked, say they would prefer to be cared for and to die at home, and a growing share of palliative care is delivered there.
Hospices deserve a special mention because they are so widely misunderstood. A hospice is not simply a building people go to die. Many offer day services, outpatient clinics, physiotherapy, counselling and short stays for symptom control, and send patients home again. According to Hospice UK, there are more than 200 hospices across the UK, caring for around 300,000 people a year – and more of that care now happens in people’s homes than in inpatient units.
The other surprise is cost. Hospice care is free to the person using it. It is funded through a mix of NHS money and charitable donations, and the charities carry most of the weight: Hospice UK reports that the NHS funds, on average, less than a third of the cost of the care hospices provide, with the rest raised from donors. So when you support a local hospice shop or fun run, you are quite literally paying for end of life care in your area.
How do you plan ahead for palliative care?
Planning ahead, sometimes called advance care planning, means recording what someone wants while they are still well enough to say so. It is one of the kindest things a person can do for their family, because it removes agonising guesswork later. There are several tools, and they are not the same thing.
- An advance statement is a general record of your wishes and preferences – where you would like to be cared for, routines that matter to you, who you want consulted. It is not legally binding, but health and care staff must take it into account.
- An advance decision to refuse treatment (an ADRT, or “living will”) is different. The NHS confirms that an advance decision “is legally binding if it complies with the Mental Capacity Act, is valid and applies to the situation”, and that “if your advance decision is binding, it takes precedence over decisions made in your best interest by other people”. It lets you refuse specific treatments in the future.
- A lasting power of attorney for health and welfare lets you appoint someone you trust to make care and treatment decisions if you later lose the capacity to make them yourself.
- A DNACPR decision (“do not attempt cardiopulmonary resuscitation”) records that attempts to restart the heart and breathing should not be made. It is recorded in the medical notes. It is important to understand that a DNACPR relates only to CPR; it does not mean other treatment, comfort care or symptom relief will be withheld.
These decisions sit on top of the Mental Capacity Act 2005, which protects people whose ability to decide may be in doubt, and overlaps with the Deprivation of Liberty Safeguards for those being cared for in restrictive settings. Planning ahead is also where honest, unhurried conversations matter most, and where good communication training earns its keep.
What is the carer’s role in palliative care?
If you are a paid care worker, a huge amount of real palliative care happens through you, in small, repeated acts rather than dramatic interventions. You help someone eat a little when their appetite has gone, reposition them so a pressure sore does not form, notice that today’s quietness is actually pain, keep them clean and comfortable, and sit with them so they are not alone. None of that is glamorous and all of it is the heart of the job.
In England, the Care Quality Commission expects providers to make sure staff have the training they need. Regulation 18 of the fundamental standards requires that staff receive “such appropriate support, training, professional development, supervision and appraisal as is necessary” for their role. There is no single law naming a specific palliative care course, but understanding what palliative care is, how to spot distress and when to escalate is a reasonable part of being competent and safe for anyone supporting people near the end of life.
It matters for family carers too. If you are looking after a relative, you are part of the palliative care team, and you are entitled to support in your own right, including respite and a carer’s assessment from your local council. Looking after yourself is not selfish; it is what lets you keep going.
Which courses cover palliative and end of life care?
These three £9 courses work well together for care workers, senior carers and anyone supporting people with a serious illness, each with a verifiable certificate:
- Palliative Care – what palliative care is, symptom and comfort support, communication and the carer’s role.
- End of Life Care – supporting someone, and their family, through the final stage of life.
- Dignity in Care – protecting privacy, choice and respect when someone is most dependent.
Pain Management in Care and Person-Centred Care are strong alternatives for teams that want to go deeper on comfort and individual wishes. Any three courses cost £18 with the pay-for-2-get-3 offer. Add them to the cart and the discount applies automatically. These are awareness courses: CPD accredited, but not regulated or clinical qualifications, and not a substitute for hands-on competency sign-off in the workplace.
Frequently asked questions
Does palliative care mean you are dying?
No. Palliative care is for anyone living with a serious illness that cannot be cured, and the NHS says it is available from when you first learn you have a life-limiting illness. Marie Curie notes that some people have palliative care for years. End of life care is the part of palliative care given when someone is close to death, but starting palliative care does not mean that point has arrived.
What is the difference between palliative care and end of life care?
End of life care is one part of palliative care. Palliative care is the whole journey of living with an incurable illness and can last months or years, often alongside other treatment. End of life care is the care given in the last part of that journey, usually taken to mean the final year, and most intensively the last weeks and days.
Is palliative care only for cancer?
No. It is for many conditions, including heart failure, advanced lung disease such as COPD, kidney failure, dementia, Parkinson’s disease and motor neurone disease. The World Health Organization reports that most adults needing palliative care worldwide have conditions other than cancer, led by cardiovascular disease.
Where can you get palliative care, and is it free?
Palliative care can be given at home, in hospital, in a care home or nursing home, and in a hospice. NHS and social care palliative treatment follows the usual NHS rules. Hospice care is free to the person using it, funded by a mix of NHS money and charitable donations, with charities covering most of the cost.
Can you still have treatment while having palliative care?
Yes. The NHS says you might receive palliative care while you are still having other therapies to treat your condition. Palliative care treats the person and their symptoms; it does not require you to stop treatment aimed at controlling the illness itself.
Comfort and dignity, from diagnosis onwards
£9 per course. CPD accredited, 100% online, verifiable e-certificate. Pay for 2, get 3 – any 3 courses for £18.
This article is general information for carers and families, not medical or legal advice. It summarises NHS, World Health Organization, NICE (guideline NG142), Marie Curie and Hospice UK guidance, and the Mental Capacity Act 2005, as they apply in the UK at the time of writing; some arrangements differ in Scotland, Wales and Northern Ireland. Always follow the advice of the person’s own medical team, your employer’s policies and the individual’s care plan. A Nexis CPD awareness course is CPD accredited but is not a regulated or clinical qualification.