Phases of palliative care

Clapham S, 2014 (revised 2021)

The Palliative Care Outcomes Collaborative (PCOC) uses phases of a life-limiting illness (and other standardised clinical assessment tools) to measure and benchmark patient outcomes in palliative care. These can be used as a communication tool between healthcare professionals caring for patients with palliative care needs. The 5 phases are described below (summarised and adapted from the PCOC clinical manual).

The palliative care phases are not sequential—a patient can move back and forth between phases.

A patient is in the stable phase when their problems and symptoms are adequately controlled or further interventions to maintain symptom control have been planned.

A patient enters an unstable phase when they develop a new problem, there is a rapid increase in severity of a current problem, or the circumstances of the family or carer change suddenly and impact on patient care.

In the deteriorating phase, a patient’s overall functional status is declining. For more information about the deteriorating phase, see Care in the last days of life.

In the terminal phase, a patient’s death is likely within days. For more information about the terminal phase, see Care in the last days of life.

The bereavement phase occurs when a patient has died and bereavement support is provided to the patient’s family and carers. For information about bereavement care, see Loss, grief and bereavement and After death care.