Registered Nurses' Association of Ontario

Nursing Best Practice Guidelines

Health Education Fact Sheet
What is hospice palliative care?
Hospice palliative care focuses on helping people with a life-limiting illness live well day to day. It includes care for the person and his/her family. Hospice palliative care can be given at the same time as treatment to cure or control disease. End-of-life care is a part of hospice palliative care that occurs during the last days and hours of life. Hospice palliative care continues beyond a person’s death to support family and friends during bereavement. This is shown in the diagram below:
Who provides hospice palliative care?
Hospice palliative care can be provided by all of the members of your health-care team, and may also include volunteers, spiritual care providers and other members of your community.
What does hospice palliative care do?
Hospice palliative care aims to:
·         Relieve pain and other distressing symptoms.
·         Help you to be involved in decisions about your care and treatment.
·         Work with you to solve problems.
·         Provide emotional support.
·         Assist you in finding information and resources.
·         Support your family during the illness and after death.
Where does hospice palliative care occur?
Hospice palliative care can be provided wherever you are. This may include:
  • at home,
  • in hospital,
  • in a long-term care facility,
  • in a retirement home,
  • in a residential hospice,
  • in a homeless shelter,
  • in a correctional facility or
  • in a group home.
How can you make your wishes known to your family and your health-care team?
It is important for your family and your health-care team to know your wishes. Some people write them down, while others talk to their family and health-care team. Both of these methods of communicating your wishes are called advance care plans.
It’s never too early to start discussions and provide direction to your family and health-care team about your care. To learn more about advance care planning, see the following free resources:
What is end-of-life care?
End-of-life care is a part of hospice palliative care that happens during the last days and hours of life.
How do you know when someone is near death?
There are some common signs as death approaches. They may include:
  • Sleeping much of the time
  • Decreased eating and drinking, or eating or drinking nothing at all
  • Weakness
  • Not passing as much urine
  • Less alert
  • Noisy breathing or changes in breathing patterns
  • Skin may feel cool and looked discoloured
  • Confined to bed
  • Restlessness, confusion or agitation
Talk to your health-care provider about how you can access hospice palliative care services in your community.
Further information is available from the Canadian Hospice Palliative Care Association at or by calling toll-free 1- 800-668-2785.
This information fact sheet is developed as a supplement to the RNAO Nursing Best Practice Guideline document for nurses. Its intent is to increase your knowledge and involvement in making decisions about your health. The nursing best practice guideline End-of-life Care During the Last Days and Hours is available for public viewing and free to download at