5 Stages of Palliative Care

What is Palliative Care? 

Palliative care is a holistic approach to comfort care designed by a multidisciplinary palliative care team of health care professionals for any aged person in any stage of serious illness. The goal is to maintain the best quality of life for the patient and their family.   

Learn more: What is Palliative Care

Goals of Palliative Care

The goals of palliative care work together in order to improve the quality of life during curative treatment for the illness or condition. The goals are:

  • Minimize pain 
  • Identify and treat symptoms (ease of physical and emotional discomfort) 
  • Keep patients active and mobile 
  • Maintain meaningful relationships with family, friends and caregivers and provide emotional support
  • Provide understanding of condition and treatment options 
  • Provide relief for family and caregivers   

Find out more about palliative care and if it is right for a patient’s needs and how to get it.

What are the Five Stages of Palliative Care

The five phases or stages of patient palliative care are: stable, unstable, deteriorating, terminal and bereavement. Understanding these phases5 can help a patient and their family decide when to start palliative care. 

Stage 1

Stage 1 means the patient is stable and has control over illness and symptoms. There is an established plan in place for symptom / pain management and quality of life improvement. The patient’s family life and caregivers are steady with relationships and caregiving with no new issues as a result of a diagnosis.  

This is the first phase of palliative care and when the overall plan is created. This phase should provide flexibility and be able to evolve with the patient’s needs. The palliative care team involved in creating this plan are: the patient, their family members and healthcare professionals such as doctors, registered nurses, social workers, volunteers, dietitians, counselors and therapists.

Stage 2

Stage 2 means the patient is unstable. The patient currently has issues that are severe and rapidly increasing. New issues may be developing as well that were not covered in the initial plan. Family life and caregiver stability have changed and cause an impact on care to the patient. Quick changes to the plan of care may be necessary along with emergency treatment. 

This is the second phase of palliative care where various health professionals such as medical social workers, counselors and chaplains step in to provide mental, emotional and spiritual support for the patient and their family. This may be accomplished through anxiety and depression counseling, religious meetings and personal activities. 

Stage 3

Stage 3 means the patient is deteriorating. The patient is experiencing decline of functions and there is a worsening of current problems or physical symptoms. New and possibly severe issues may have developed. Family life and caregiving stability is deteriorating and in distress. This decline leads to an impact on the quality of the patient’s care. The plan of care at this phase means re-evaluating the patient’s needs and addressing the declining state of symptoms.

This is the third phase of palliative care where the palliative care team consists of medical professionals such as nurses and physicians work to maintain patient independence. At this phase, home health aides and assistance from nurses may be required in order to support daily activities. This is also an important phase for emotional support from team members such as counselors and therapists.

Stage 4

Stage 4 means the patient is terminal. Within days, death is expected. The patient may experience severe symptoms such as being bedridden, having mobility issues, decrease in appetite, difficulty with taking medications and requiring daily medical assistance. The plan now focuses on change of care to include physical, psychological and spiritual comfort. There is a focus on end of life medications. At this phase, the care plan may be under constant review. 

This is the fourth phase of palliative care where there may be plans to arrange inpatient care. If desired, this can take place at a hospital setting with greater access to medical care or within hospice. If a patient would rather accept help through the comfort of their home, live-in-care may be arranged. This phase may include the full spectrum of end of life care. 

Stage 5 

Stage 5 means the family and caregivers are in bereavement because the patient has passed on. The plan now assists in providing support to families and caregivers. 

This is the fifth and final phase of palliative care. This type of bereavement support is offered to the patient’s friends and families and typically may be utilized anywhere from months to a year (or as long as a family needs it). This type of care may include emotional support such as grief counseling groups, other support groups and religious chaplain support. 


Is palliative care the same as hospice care?

No, palliative care is a multidisciplinary approach to comfort care designed for any aged individual in any stage of a serious or chronic illness. Hospice care, though a type of palliative care, is specially designed for end of life care where a patient has a terminal illness, curative treatment is no longer an option, and life expectancy is less than a year. 

Learn more: What’s the difference between palliative and hospice care?

When is palliative care appropriate?

Palliative care is appropriate for any aged individual diagnosed in any stage of a serious or life threatening illness. A referring or diagnosing physician may refer a patient to a palliative care specialist.

Related:When Should Someone Be Offered Palliative Care?

How long can you be in palliative care?

As long as a patient needs it. There can also be a transfer out of palliative care if it is no longer beneficial. 

What’s the difference between palliative care and end of life care?  

Palliative care may begin at any point after a diagnosis and may continue for years if needed. End of life care may begin at the final stage of life (usually with less than a year left of life expectancy). Palliative care plans may continue along with end of life care.


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