For most families navigating a serious or life-limiting illness, palliative care is unfamiliar territory. In this guide we’ll explain what palliative care is, when it begins, and what the five recognised stages involve. We hope this will help to bring clarity and reassurance, offering a structured understanding of how care develops over time.
You will also find guidance on how early palliative support enhances comfort, independence, and emotional well‑being, along with insight into how families can prepare at each stage of the journey. Throughout, we highlight the attentive, expert approach Draycott Nursing & Care brings to palliative care at home, ensuring that individuals and their loved ones feel supported, informed, and understood.
Here's what we'll cover:
What palliative care is
Why understanding the five stages is important
The five stages of palliative care
When palliative care starts
The benefits of palliative care
What is Palliative Care?
Palliative care is a holistic approach to supporting people living with serious, chronic, or life‑limiting illnesses. Its purpose is to improve quality of life by managing symptoms, reducing discomfort, and offering emotional, psychological, and spiritual support. While often confused with end-of-life care, the two are distinct: palliative care encompasses care at any stage of a serious illness and may include the other, whereas end-of-life care specifically focuses on comfort and support during the final phase of life.
This type of care can include specialist symptom management, support with daily activities, coordination between different medical teams, and guidance for families as they navigate complex decisions and potentially begin to deal with grief. It brings together clinical expertise and compassionate insight to ensure that the individual’s comfort, dignity, and personal wishes remain at the centre of their care.
You may also have heard of hospice care and have questions about the differences between the two. In short, hospice care supports individuals in the final months of life, whereas palliative care can begin at any stage of an illness - even alongside curative or life‑prolonging treatments. It is designed to help people live as comfortably, independently, and meaningfully as possible.
Why Understanding the Stages of Palliative Care Matters
The five stages model of palliative care has its origins in early frameworks developed to help families understand how care naturally progresses as needs evolve, offering a clear pathway from initial assessment through to end‑of‑life and bereavement support.
Knowing the five stages of palliative care helps individuals and their families anticipate what to expect, both emotionally and practically. Understanding these stages also ensures that care aligns with personal values, preferences, and goals, enabling thoughtful planning and informed decision‑making. When families recognise how palliative care evolves, they are better equipped to access support early and to navigate the journey with confidence.
The 5 Stages of Palliative Care
The five stages of palliative care offer a clear framework for understanding how support evolves as needs change. Before exploring each stage in depth, it may be helpful to see the full pathway at a glance:
Creating a personalised care plan
Early intervention and symptom management
Emotional and spiritual support
Advanced care planning
End‑of‑life and bereavement support
Together, these stages form a process that supports comfort, dignity, and emotional well‑being throughout the course of an illness. In the sections that follow, we examine each one in detail, so families know what to expect at every step.
Note: different organisations describe the "five stages of palliative care" in varying ways. This guide follows a care‑process model commonly used in home‑based palliative services, focusing on the support families can expect at each step.
Stage 1: Creating a Personalised Care Plan
Stage one begins with a thorough assessment of a person’s physical symptoms, emotional needs, medical history, and daily routines. This process often includes conversations with family members, GPs, consultants, and existing support networks.
A multidisciplinary team - which may include nurses, carers, physiotherapists, and specialists - is formed around the individual to establish both short‑ and long-term goals. Short-term goals may include things like stabilising symptoms or improving mobility, while longer‑term aims might be maintaining independence at home or preparing for future care needs.
At this early stage, palliative care is about clarity, stability, and building the right foundation.
Stage 2: Early Intervention and Symptom Management
The second stage focuses on proactively managing symptoms. This may involve controlling pain, easing breathlessness, addressing fatigue, or managing the side effects of ongoing treatments like chemotherapy or radiotherapy.
At this stage palliative care runs alongside curative efforts and helps the person continue living as fully as possible. Early intervention often prevents symptoms from escalating and can have significant impacts on day‑to‑day comfort. It also helps families feel more supported, knowing that trained professionals can respond quickly to changing needs.
Stage 3: Emotional and Spiritual Support
Serious illness has effects beyond physical symptoms. Stage three recognises the profound emotional, psychological, and spiritual questions that often come to the fore when a person is unwell and potentially grappling with their mortality.
Individuals and their loved ones may experience fear, sadness, uncertainty, or the need to make sense of their situation. Palliative care teams include professionals such as counsellors, social workers, chaplains, and therapists who help individuals explore these feelings safely.
This stage encourages honest, open communication - conversations about hopes, concerns, and values - allowing families to feel empowered and more connected as they move forward.
Stage 4: Advanced Care Planning
As the person’s needs evolve, advanced care planning becomes essential. This stage involves thoughtful discussions about preferences for future medical treatment, including decisions around resuscitation, hospital admissions, medication management, and preferred place of care.
Creating documents such as advance directives or Do Not Resuscitate (DNR) orders helps ensure that a person’s wishes are respected if they become unable to communicate them. Palliative care professionals guide families through legal and ethical considerations, helping to reduce uncertainty and ensure that choices are honoured with dignity.
Stage 5: End‑of‑Life and Bereavement Support
The final stage focuses on comfort, peace, and dignity during the last days or weeks of life. When appropriate, individuals may transition from palliative care into hospice‑level care, though many prefer to remain at home surrounded by familiar comforts.
Nurses provide expert symptom management, ensuring that pain, breathlessness, and anxiety are minimised. Families receive guidance, reassurance, and practical help. After a person passes away, bereavement counselling and grief support continue for their loved ones, helping them navigate the emotional landscape that follows loss.
At What Stage Does Palliative Care Start?
Palliative care may be suggested at various points in an illness, depending on a person’s symptoms, diagnosis, and overall needs. In most cases, the recommendation comes from a GP, hospital consultant, specialist nurse, or multidisciplinary team who recognise that additional support would improve comfort and well‑being. It may also be introduced when treatments become physically or emotionally challenging, or when families feel they need more structured guidance at home.
Palliative care can start alongside active treatment for conditions such as cancer, heart failure, dementia, COPD, Parkinson’s disease, and many others. Beginning early ensures that care is proactive rather than reactive, giving individuals the best chance of maintaining independence and personal control.
It is important to remember that palliative care being suggested - or even beginning - is not a sign that active treatment is ending: it is a layer of support that can begin early and run alongside ongoing care.
Read more: our introductory guide to end of life care
The Benefits of Palliative Care
Palliative care offers a wide range of benefits for both individuals and their families, improving quality of life long before end‑of‑life care becomes necessary. One of the most significant advantages is expert symptom management: pain, nausea, breathlessness, restlessness, and fatigue are addressed with skill and attentiveness, helping people remain comfortable and independent for as long as possible. Early involvement can also reduce unnecessary hospital admissions, allowing individuals to receive care in the place where they feel most at ease.
Beyond physical comfort, palliative care provides emotional and psychological support tailored to each person’s needs. Living with a serious illness can be overwhelming, and having access to counsellors, nurses, and social workers creates a safe space to express fears, hopes, and uncertainties. This holistic support extends to families, helping them understand what to expect, make informed decisions, and cope with the emotional demands of caregiving.
Another essential benefit is continuity of care. Palliative teams coordinate seamlessly with GPs, specialists, therapists, and community services, ensuring that everyone involved in an individual’s care works from the same plan. This coordination reduces stress, avoids gaps in care, and supports smooth transitions between stages of illness.
Palliative care also empowers individuals to make meaningful choices. Through early conversations about preferences, values, and long‑term wishes, people regain a sense of control at a time when life can feel unpredictable. This clarity offers reassurance not only to the person receiving care but also to their family, who gain confidence in knowing how best to honour their loved one’s wishes.
Draycott Nursing: Expert Palliative Care at Home
Palliative care at home enables people to remain in familiar surroundings while receiving the highest standard of professional support. Draycott Nursing & Care is a specialist provider of home‑based palliative care, accredited for excellence in end‑of‑life support.
Our teams combine clinical expertise with warmth, sensitivity, and discretion, ensuring that every stage of the palliative journey is handled with care. From the first assessment to advanced care planning and ongoing symptom management, our nurses help individuals live comfortably, while providing families with reassurance and expert guidance.
To learn more about our approach, including our Gold Standard end‑of‑life accreditation, please visit our dedicated palliative and end‑of‑life care page.
