Understanding Palliative Care:
What it is, when it may be helpful, and how to support patients and families.
Myth busting:
Palliative care is often thought of as care for the final stages of life, but it can be introduced much earlier.
Alongside disease-directed treatment, it can support symptom management, quality of life, decision-making, and the wider needs of patients and family.
“Talking about palliative care will take away hope.”
These conversations do not have to remove hope. They can help people understand what is happening, prepare for possible changes and identify what matters most to them, while still holding hope for the things that remain important.
Support,
Choice,
Connection
& Planning
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Support, Choice, Connection & Planning *
“Palliative care is only for the last days of life.”
Not necessarily. Palliative care can be introduced much earlier in the course of illness and may be helpful for months or even years, depending on a person’s needs.
“It means there is nothing more that can be done.”
There is often a great deal that can still be done. Palliative care broadens the focus of care to include symptom management, quality of life, communication, decision-making and what matters most to the person and their family.
“It means stopping treatment.”
This is an important misconception to address clearly. Palliative care does not automatically mean stopping treatment. Disease-directed therapies may continue alongside palliative care, together with supportive and comfort-focused care aimed at managing symptoms, improving quality of life and helping someone live as well as possible.
“A referral to palliative care means the person is actively dying.”
Not necessarily. Referral can happen much earlier, particularly when there are complex symptoms, difficult decisions, changing goals of care or a need for additional support for the person and their family.
“Palliative care is only the responsibility of specialist teams.”
A palliative approach can be provided by the person’s usual healthcare team, with specialist palliative care involved when needs are more complex or additional expertise is required.
“Palliative care is only about pain relief.”
Pain and symptom management are important, but the scope is much broader. Palliative care also considers emotional, practical, social, cultural and spiritual needs, alongside communication, planning and support for family.
“Palliative care only happens in hospice.”
Palliative care can be provided in many settings, including at home, in hospital, in aged residential care and in the community. Hospice and specialist palliative care services are part of this wider approach, rather than the only place palliative care happens.
Why earlier palliative care matters:
Palliative care focuses on quality of life, comfort, dignity and support for people living with serious or life-limiting illness.
It is not limited to the final days or weeks of life. Palliative care can be introduced much earlier, alongside disease-directed treatment, and can support patients and whānau through changing needs, complex symptoms, difficult decisions, uncertainty and future planning.
It may include support with:
managing pain, symptoms and treatment-related concerns
helping people understand their illness, treatment options and what may lie ahead
exploring goals, values, priorities and what matters most
planning ahead for future care and possible changes
supporting families, carers and children
attending to emotional, social, cultural and spiritual wellbeing
navigating complex health and care systems
supporting communication and shared decision-making across teams
It creates space for honest conversations, thoughtful planning, comfort and connection, while keeping the person - not just the illness - at the centre of care.
Palliative support: where to start?
You do not need to wait for a specialist palliative care referral to begin providing palliative support.
Many aspects of a palliative approach - including symptom management, emotional support, planning ahead and conversations about what matters most - can begin within the person’s usual healthcare team, often from the time of a serious or complex diagnosis.
Starting these conversations early gives people and their families more time to understand their options, consider what matters to them and prepare for what may lie ahead, without feeling that every decision needs to be made at once.
Earlier palliative support can come from:
GPs and Nurse Practitioners: symptom management, medication review, advance care planning and coordination of care
Practice, District and Community Nurses: monitoring symptoms, providing practical support and helping coordinate care at home and in the community
Disease-specific teams such as oncology, respiratory, cardiac, renal or neurology: integrating symptom management, quality of life and future-care conversations alongside treatment
Paediatric teams: supporting children and young people with symptom management, care planning, communication and coordination, with specialist palliative care involvement when additional expertise is needed
Allied Health Professionals: including social workers, physiotherapists, occupational therapists, dietitians and psychologists, supporting function, wellbeing, adjustment, practical needs and quality of life
Māori and Community Health Providers: providing culturally responsive, practical and whānau-centred support, and helping connect people with services that fit their needs
Aged Residential Care Teams: providing ongoing comfort, symptom management and care planning, with specialist palliative care involvement when additional support or expertise is needed
Hospice Services: in some areas, offering advice, education, carer support, day programmes and other support alongside or before more intensive specialist palliative care input is required
Knowing what primary palliative support is available locally can make a real difference. Helping people and their families connect with support early can give them more choice, more time to plan, and a clearer sense of who is there to help.
In New Zealand, palliative care is often described as primary palliative care or specialist palliative care.
Primary palliative care is provided by the person’s usual healthcare team and can include symptom management, communication, care planning and support for their family.
Specialist palliative care is provided by dedicated palliative care teams when needs are more complex, such as difficult-to-manage symptoms, complex decision-making, or significant psychosocial, cultural or spiritual support needs.
What support can hospice care provide?
Hospice services provide specialist palliative care for adults and children whose symptoms, decision-making or wider support needs require additional expertise.
Hospice care is not limited to symptom management or the final days of life. It takes a holistic approach, supporting the physical, emotional, social, cultural and spiritual needs of the person, while also providing support for their families and carers.
Depending on the local hospice and the person’s needs, support may include pain and symptom management, specialist nursing and medical care, emotional and cultural support, practical guidance, support for family and carers, spiritual care and bereavement support.
Care may be provided at home, in the community, in aged residential care, in hospital or within a hospice facility. Hospice is not simply a place someone goes to die - it is a specialist service that can support people and their families across different stages of serious illness.
Hospice services vary across New Zealand, but care is generally provided free of charge to people receiving hospice services.
Referral pathways differ between services. Referrals are commonly made by a GP or another member of the healthcare team and some hospices also accept self-referrals.
Find out more through Hospice New Zealand:
Hospice New Zealand provides information about hospice and specialist palliative care across Aotearoa, along with resources, education and professional development opportunities for people working in health and care.
Not sure how to start a conversation about palliative care?
Starting a conversation about palliative or hospice support can still feel difficult, particularly when someone is receiving active treatment or their future needs are uncertain. But waiting for a crisis can leave people, their families and teams with less time and fewer options.
Earlier conversations can support more proactive care by helping people understand what support is available, explore what matters most, prepare for possible changes and make decisions gradually over time.
They do not mean that every decision needs to be made now, or that the focus has shifted entirely to end-of-life care. They simply create more space for shared understanding, planning and choice.
The Caring Conversations Project offers practical resources that build on the knowledge and skills health professionals already have, with prompts, tools and ideas to support meaningful conversations about care, uncertainty, values and future planning.