For families navigating a life-limiting illness, understanding the care journey is crucial. Many people search for “what are the 5 stages of palliative care” seeking clarity. In Australia, this journey is guided by a clinical framework of five distinct “phases” that ensure care adapts to a person’s changing needs, from diagnosis through to bereavement.
The five palliative care phases are: Stable, Unstable, Deteriorating, Terminal, and Bereavement. This evidence-based model, used by healthcare teams across the country, provides the right support at the right time. This guide explains each phase in detail, using information from trusted authorities like NSW Health, the Australian Government Department of Health, and the World Health Organization (WHO).
The five palliative care phases are:
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Stable
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Unstable
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Deteriorating
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Terminal
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Bereavement
This evidence-based model helps healthcare teams provide the right support at the right time. This guide explains each phase in detail, using information from trusted authorities like NSW Health, the Australian Government Department of Health, and the World Health Organization (WHO).
What Is Palliative Care?
Palliative care is a holistic approach that improves the quality of life for patients of any age facing a life-limiting illness. Its goal is to prevent and relieve suffering by managing physical, emotional, social, and spiritual challenges. Crucially, it is not just for the end of life; it can begin at any stage of an illness and be provided for years alongside curative treatments.
Palliative Care vs. Grief Stages: Clearing Up the Confusion
It’s common to confuse the palliative care phases with the “five stages of grief” (denial, anger, bargaining, depression, acceptance). These are different concepts:
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Palliative Care Phases are a clinical framework describing the progression of a patient’s medical condition and how care is adapted.
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Stages of Grief are a psychological model describing the emotional responses a person may have to loss.
A patient in the terminal phase may experience grief, and their family will navigate their own grief journey during the bereavement phase, but the two models serve different purposes.
The 5 Phases of Palliative Care in Detail
Australia’s five-phase model is flexible, and a person might move between phases as their condition changes.
1. Stable Phase
In the stable phase, symptoms are well-managed by the current care plan. The focus is on maintaining quality of life and planning ahead. This is an ideal time for advance care planning to document treatment preferences.
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Key questions to ask: Who is on my care team? Where can I receive care? What does my future likely look like?
2. Unstable Phase
This phase is marked by a sudden change in a patient’s condition or a new, complex symptom requiring urgent intervention. Data from the Australian Institute of Health and Welfare (AIHW) shows that this phase is often managed effectively, with 86% of unstable episodes resolved within three days.
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Key questions to ask: Is there an emergency plan if symptoms worsen? What are my urgent treatment options?
3. Deteriorating Phase
Here, the patient experiences a gradual but progressive decline. The care team focuses on managing comfort and adapting the plan to meet evolving needs, with an emphasis on emotional support for both the patient and their family.
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Key questions to ask: How can I remain as comfortable as possible? What equipment or home modifications might help?
4. Terminal Phase
The terminal phase refers to the final days or hours of life. The sole focus is on ensuring the patient is comfortable, peaceful, and dignified. Intensive emotional and spiritual support is provided to the patient and their loved ones.
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Key questions to ask: What comfort measures are available? What final decisions need to be made about my care?
5. Bereavement Phase
Palliative care continues after death by supporting family, friends, and carers. This may include grief counseling, group therapy, or referrals to community services like Griefline.
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Key questions to ask: What support is available for my family? How can we access grief counseling?
The Palliative Care Team and Where Care Is Provided
Palliative care is delivered by a multidisciplinary team including doctors, nurses, social workers, physiotherapists, psychologists, and trained volunteers. In 2023, Australia’s specialist workforce included 358 palliative medicine physicians and approximately 3,900 palliative care nurses.
This care can be provided in a variety of settings depending on patient preference:
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At home, with support from visiting health professionals and virtual care.
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In a hospital or dedicated palliative care unit.
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In a residential aged care facility.
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In a hospice offering specialized end-of-life support.
Palliative Care in Australia and Globally
Australia’s palliative care system is growing to meet demand. Hospitalizations rose by 46% to 107,500 between 2015 and 2024, and prescriptions increased by 59% in a similar period. Despite this, the need is vast. The WHO reports that while 56.8 million people globally require palliative care annually, only about 14% receive it, making access a critical human rights issue.
Getting Started with Palliative Care in NSW
If you or a loved one could benefit from palliative care, the first step is to speak with a GP. They can provide support, facilitate advance care planning, and refer you to specialist services. For 24/7 advice, the healthdirect helpline is available around the clock. You can also find easy-read materials and other resources to support family discussions on the NSW Health website.
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Palliative Care Phases: https://pmc.ncbi.nlm.nih.gov/articles/PMC8364299/
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Palliative Care Services in Australia: https://www.aihw.gov.au/reports/palliative-care-services/palliative-care-services-in-australia/contents/summary
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NSW Health – Palliative Care: https://www.health.nsw.gov.au/palliativecare/Pages/default.aspx
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Australian Government Department of Health – What is Palliative Care?: https://www.health.gov.au/topics/palliative-care/about-palliative-care/what-is-palliative-care?language=en
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World Health Organization – Palliative Care: https://www.who.int/news-room/fact-sheets/detail/palliative-care
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Agency for Clinical Innovation (ACI) – Palliative and End of Life Model of Care: https://aci.health.nsw.gov.au/__data/assets/pdf_file/0006/894921/ACI-FWLHD-palliative-and-end-of-life-model-of-care.pdf
