When someone you care about is receiving palliative care, the language used by clinical teams can feel unfamiliar and sometimes frightening. Phases. Deteriorating. Terminal. These are words that arrive in your life without warning, and they deserve to be explained plainly and with care, not buried in clinical documentation you have to decipher on your own.
In Australia, palliative care teams across hospitals, hospices, and community home care services use a standardised set of five clinical phases to describe a person’s condition and guide their care. These phases were developed by the Australian Association for Hospice and Palliative Care in 1993 and are now used nationally by the Palliative Care Outcomes Collaboration (PCOC) to benchmark and improve palliative care quality across the country. In 2024, 202 services across Australia participated in PCOC, delivering care to 72,400 patients (AIHW 2025).
This guide explains each phase in plain language, including what it involves clinically, what families typically experience, how long phases tend to last based on AIHW data, and what care and funding is available at each point. One thing matters above everything else before you read further: the palliative care phases are a clinical framework, not a predetermined timeline. A person can move between phases in any direction, return to an earlier phase, and the phases are not a sentence.
What Palliative Care Actually Is
Palliative care is often misunderstood as something that only happens in the final days of life. It is not. The World Health Organization defines it as an approach that improves the quality of life of patients and families facing a life-threatening illness, through prevention and relief of suffering by early identification and treatment of pain and other physical, psychological, and spiritual issues. In Australia, the AIHW and Palliative Care Australia both emphasise that palliative care can and should begin early, often at the same time as curative or life-prolonging treatment.
Palliative care addresses the whole person. That means managing physical symptoms like pain, breathlessness, and nausea. It also means addressing emotional distress, supporting family members, helping with practical planning, and providing spiritual or cultural support if that is important to the person. The team involved typically includes a GP, specialist palliative care physicians and nurses, allied health professionals, social workers, chaplains, and community support workers.
In 2023-24, pain relief medications accounted for 79% of the 1.4 million palliative care-related prescriptions in Australia (AIHW 2025). The same year, the Australian Government spent $37.9 million on palliative care medications from the PBS Palliative Care Schedule. These figures reflect the significant and growing scale of palliative care in Australia, alongside the government’s commitment to supporting people through serious illness at home and in community settings.
Palliative care is available through public hospitals, private hospitals, residential aged care facilities, hospices, and increasingly, at home through community-based palliative care services. For older Australians, home-based palliative care has been significantly strengthened through the Support at Home End-of-Life Pathway, introduced on 1 November 2025.
The 5 Palliative Care Phases at a Glance
The five PCOC palliative care phases are used daily in Australian clinical settings to describe where a person is in their illness journey and whether the current care plan is meeting their needs. Each phase is defined by the clinical situation and the effectiveness of the existing care plan, not by a fixed disease stage or timeframe.
According to AIHW data from 2024, across the 95,500 palliative care episodes recorded in PCOC: 42% were deteriorating phases, 32% were stable phases, 15% were terminal phases, and 11% were unstable phases. The higher proportion of deteriorating and terminal phases in inpatient settings (62%) compared with community settings (53%) reflects the tendency for people to be admitted to hospital or hospice when their condition becomes more acute.
The five phases are: Stable (illness is managed, the current care plan is working), Unstable (a sudden change has occurred that requires urgent review), Deteriorating (a gradual ongoing decline with increasing care needs), Terminal (the final days or weeks of life), and Bereavement (the period after death, with support continuing for family and carers).
A phase changes when the existing care plan is no longer effective for the person’s current situation. That is the key principle. The phases are not defined by disease progression alone, but by whether the care being provided is still adequate and appropriate.
Phase 1: The Stable Phase
In the stable phase, the person’s illness and symptoms are being managed by the current care plan. Their situation is not necessarily good. They have a life-limiting illness. But their symptoms are adequately controlled, their condition is not changing rapidly, and the care being delivered is meeting their needs. Life continues with support.
What the Stable Phase Involves
At this point, the focus is on quality of life, maintaining independence where possible, and planning ahead. The person and their family work with their care team to develop an advance care plan, discuss goals of care, and identify what matters most to them as the illness progresses. This is also the time to think about where the person wants to receive care as their needs increase, including whether staying at home is their preference and what supports would make that possible.
Symptom management in the stable phase is active but not crisis-driven. Medications are reviewed regularly, allied health supports (physiotherapy, occupational therapy, social work) may be involved, and community nursing visits are typically scheduled rather than urgent.
How Long the Stable Phase Lasts
AIHW data from 2024 shows stable phases last an average of 23 days in community settings and 5.7 days in inpatient settings. Some people remain in the stable phase for months or longer. This phase is often much longer than families anticipate, which is why beginning support and planning early makes a significant practical difference.
What Families Experience in the Stable Phase
This phase can carry a complicated emotional weight. The person is ill, but not acutely declining. Families often feel a mix of relief, grief, and uncertainty about what comes next. This is a good time to establish care routines, connect with support services, and have honest conversations about future wishes while the person can actively participate in those decisions.
Phase 2: The Unstable Phase
A person enters the unstable phase when something changes suddenly. A new symptom emerges. An existing symptom worsens significantly. A complication arises that the current care plan was not designed to handle. The clinical team needs to assess urgently and modify the care plan. This phase is characterised by change and the need for rapid response.
What the Unstable Phase Involves
The unstable phase triggers urgent clinical review. This might mean a GP visit, contact with the palliative care nurse or specialist, medication adjustment, a short hospital admission for symptom stabilisation, or an emergency family meeting. The care plan is actively revised to address whatever has changed. The goal is to stabilise the person and return them, where possible, to a stable phase with a revised and better-aligned care plan.
Patients in an unstable phase are more likely to rate their symptoms as moderate or severe than patients in any other phase, according to AIHW Symptom Assessment Scale data from 2024. This is the phase where prompt access to clinical support makes the most measurable difference to symptom control and quality of life.
How Long the Unstable Phase Lasts
The unstable phase tends to be the shortest of the five. The clinical goal is resolution, either through stabilisation back to a stable phase or recognition that the person has moved into a deteriorating or terminal phase. Families often find this phase the most frightening because the change is sudden and the outcome is uncertain.
What Families Experience in the Unstable Phase
For many families, the unstable phase is the first moment the full reality of the illness becomes visceral rather than abstract. Having a clear after-hours contact for the palliative care team, knowing who to call, and understanding the difference between what warrants a 000 call versus a call to the nursing team is important practical preparation that should happen before a crisis, not during one.
Phase 3: The Deteriorating Phase
The deteriorating phase is defined by gradual, ongoing decline. The illness is progressing. The person’s care needs are increasing over time. Unlike the unstable phase, this is not a sudden change, it is a sustained trajectory. The care plan is being adjusted regularly to keep pace with increasing needs, but no single adjustment resolves the situation because the underlying illness continues to progress.
What the Deteriorating Phase Involves
At this stage, care typically intensifies. Nursing visits become more frequent. Personal care needs increase. Medications are adjusted more often. Conversations about goals of care become more urgent and specific: where does the person want to be when they die? What interventions do they want or not want? What does a good death look like for this person? Advance care plans should be in place and accessible to all care team members by this phase.
This is also the phase where family carers tend to experience their highest levels of fatigue and psychological strain. Respite care, carer support services through the Carer Gateway (1800 422 737), and bereavement preparation all become relevant. Research consistently shows that carer burnout accelerates when respite is not in place before this point.
How Long the Deteriorating Phase Lasts
The deteriorating phase averages 15 days in community settings and 4.7 days in inpatient settings (AIHW 2024). It is the most commonly recorded phase in Australian palliative care data (42% of all phases). The duration varies significantly by diagnosis, with some conditions (such as heart failure or COPD) having longer and less predictable deteriorating phases than others.
What Families Experience in the Deteriorating Phase
The deteriorating phase is where the practical and emotional demands on families peak. This is the time to ensure that care supports are maximised, that the person’s goals are clearly documented, and that the family has access to psychological support. If your loved one is receiving home care through Support at Home, this is also the point to begin exploring the End-of-Life Pathway with their provider, before eligibility is triggered.
Phase 4: The Terminal Phase
The terminal phase is defined as the final days to weeks of life. Death is expected in the near term. The focus of care shifts entirely to comfort and dignity. The goal is no longer to manage the illness or maintain function, but to ensure the person experiences as little suffering as possible and that their final time is spent in the way that matters to them.
What the Terminal Phase Involves
Clinical management in the terminal phase prioritises symptom control above all else. Oral medications may be replaced with subcutaneous infusions for more reliable symptom management. Nutrition and hydration decisions are made in line with the person’s wishes and comfort, rather than clinical targets. Unnecessary interventions are withdrawn. The care team focuses on pain, breathlessness, agitation, nausea, and other distressing symptoms.
This phase also involves significant practical and emotional support for the family. Many families who choose to have their loved one die at home need guidance on what dying looks like physically, what is and is not normal, and when to call for support. Most people (research estimates between 58 and 90% across studies) would prefer to die at home surrounded by family. Despite this, AIHW data shows that around 55% of palliative care hospitalisations in 2022-23 ended with the patient dying in hospital, suggesting that the preference and the reality remain some distance apart.
Signs That Someone May Be Entering the Terminal Phase
Clinical signs that may indicate a person is transitioning into the terminal phase include: significantly reduced oral intake over several days, increasing drowsiness or reduced responsiveness, changes in breathing pattern (including longer pauses), peripheral mottling or colour changes in the skin, withdrawal from interaction, and loss of interest in surroundings. These signs should prompt contact with the palliative care nursing team rather than an emergency call, unless the person is in acute distress.
AIHW Data on Referral and the Terminal Phase
One of the most confronting statistics in Australian palliative care data is this: the median number of days from referral to death was just 6 days in 2024 (AIHW 2025). This reflects how late many Australians are referred to specialist palliative care services relative to their need. Earlier referral, ideally at the point of diagnosis with a life-limiting illness rather than in the final days, is consistently associated with better symptom management, fewer hospital admissions, and greater likelihood of dying in the person’s preferred setting.
Phase 5: The Bereavement Phase
Bereavement is formally recognised as a palliative care phase in Australia, not as a separate service or an afterthought, but as an integral part of the care continuum. The person has died. The care continues, directed now at the family and carers who are living with that loss.
What the Bereavement Phase Involves
Most Australian palliative care services make contact with families within the first weeks after a death as part of bereavement follow-up. This may involve a phone call from the nursing team, a visit from a social worker, or a referral to a dedicated bereavement counselling service. The nature and duration of bereavement support varies by service and individual need.
Bereavement support can include individual counselling, group programs for bereaved people, peer support, and practical assistance with tasks like navigating paperwork and services after a death. Research from a 2025 scoping review published in the journal Palliative Care and Social Practice found that initial contact usually occurs within the first week post-death, with follow-up continuing through 6 weeks to 6 months depending on individual need and service capacity.
Australian Bereavement Support Resources
Families in Australia navigating bereavement can access the following services. These phone numbers have been verified against current Australian Government and service provider sources as of June 2026:
Griefline: 1300 845 745 (free confidential counselling for grief and loss, available nationally including regional and remote areas). Carer Gateway: 1800 422 737 (connects carers with counselling, coaching, and practical support). Beyond Blue: 1300 22 4636 (24-hour mental health support). Lifeline: 13 11 14 (24-hour crisis support). Palliative Care Australia: palliativecare.org.au (can connect families with state-based bereavement services). Local hospital palliative care teams also typically offer bereavement follow-up as part of their service model.
Supporting Carers Through Bereavement
Family carers often carry anticipatory grief through the deteriorating and terminal phases, grieving for the person while still caring for them. After the death, this grief does not start fresh: it continues and transforms. Carers who have been providing intensive care often experience a profound loss of identity and purpose alongside the loss of the person themselves. Recognising this and seeking support early, rather than waiting until distress becomes crisis, is consistently recommended by palliative care and grief specialists.
Why the Palliative Care Phases Are Not a Straight Line
This is one of the most important things to understand about the palliative care phase model, and one that is most often misrepresented in online content.
The phases were not designed as a progression from stage 1 to stage 5. They were designed to reflect the current clinical situation at any given moment. According to the PCOC framework and peer-reviewed research, the phases do not have a linear trajectory due to the unpredictable progression of incurable diseases and patients’ individual goals and needs. Phases can alternate and occur several times.
AIHW data from 2024 reports that patients in inpatient settings had an average of 2.4 phases per episode of care. That means a person might move from stable to unstable, back to stable, into deteriorating, briefly back to unstable, and then into terminal. Or they might remain in stable for months and transition directly to terminal with very little warning. The trajectory depends entirely on the person, their diagnosis, their treatment, and their individual circumstances.
This matters enormously for families. It means that a move into the deteriorating phase is not a one-way door. It means that an episode of instability does not inevitably mean the person is dying. And it means that the focus of care at any given time should be on the person’s current situation, not on where they might be heading according to a simplified model.
Receiving Palliative Care at Home in Australia
Most Australians, when asked, say they want to die at home. That preference is well-documented and increasingly supported by government policy and funding. Community-based palliative care at home is available across Australia through a combination of state and territory specialist palliative care services, GP-led community care, and registered home care providers.
What Home Palliative Care Includes
In the community setting, palliative care at home typically includes regular nursing visits for symptom assessment and medication management, allied health support (physiotherapy for breathlessness or mobility, occupational therapy for equipment and home modification), personal care assistance with showering, dressing, and continence, domestic assistance, social support and companionship, and access to after-hours clinical advice and emergency visits. Respite care for family carers is also a critical part of effective home palliative care.
Government-Funded Palliative Care at Home
For older Australians eligible for the Support at Home program, palliative care at home is funded through a combination of Support at Home classifications (which fund nursing and allied health with no participant contribution) and the End-of-Life Pathway (a dedicated $25,000 funding stream for people with three months or less to live). State and territory specialist palliative care services also operate independently of the aged care funding system and can provide additional clinical support.
For NDIS participants under 65, NDIS support can include nursing and personal care at home. The NDIS does not fund palliative care as a specific category, but relevant supports can be included in a plan where they relate to the participant’s disability-related needs.
Why Early Planning Makes a Difference
The AIHW statistic about a median referral-to-death of just 6 days reflects a systemic problem: too many Australians are referred to palliative care very late. Families who engage with palliative care services earlier, ideally while the person is still in the stable phase, have more time to establish care routines, access equipment, arrange after-hours support, and make informed decisions about what the final phase will look like. Late referral compresses this planning into a crisis period when families are least equipped to make complex decisions clearly.
The Support at Home End-of-Life Pathway (2026)
One of the most significant changes in Australian aged care in 2025 is the introduction of a dedicated funding pathway for end-of-life care at home. This pathway was introduced on 1 November 2025 under the Support at Home program and the Aged Care Act 2024.
Who Is Eligible
To access the End-of-Life Pathway, a person must meet all of the following criteria: they must be aged 65 and over (or 50 and over for Aboriginal and Torres Strait Islander peoples, or 50 and over if homeless or at risk of homelessness); they must have received a clinical assessment from a doctor or nurse practitioner confirming a life expectancy of three months or less; and they must have an Australian-modified Karnofsky Performance Status (AKPS) score of 40 or below, indicating a significant decline in physical function and independence. Only one episode of the End-of-Life Pathway is permitted per participant.
What the Pathway Provides
The pathway provides up to $25,000 in government funding over 12 weeks, with the option to extend to 16 weeks if funds remain. This funding is separate from the person’s existing Support at Home classification budget, so accessing it does not reduce their regular weekly service hours. The funding can be used for nursing, personal care, domestic assistance, and other practical supports that enable the person to remain at home. Clinical services (nursing, allied health) are fully funded under the clinical supports category with no participant contribution. Other services may attract a means-tested contribution.
How to Access the Pathway
To access the End-of-Life Pathway, the doctor or nurse practitioner completes the End-of-Life Pathway Form with the person and their family. Existing Support at Home participants can request an urgent Support Plan Review through their provider to transition to the pathway. New participants can apply directly through My Aged Care on 1800 200 422 and request fast-tracked assessment given the clinical urgency. The pathway is designed to bypass normal waiting lists, reflecting the time-sensitive nature of eligibility.
What Happens After 12 Weeks
If the person continues to live beyond the initial 12-week pathway period and has remaining funds, they can continue to use the budget up to the 16-week mark. After that, their provider can request a Support Plan Review to transition them to an ongoing Support at Home classification. The government has also indicated it is working on a second round of funding for participants who live beyond the initial pathway period, acknowledging that prognosis is inherently uncertain.
For a broader explanation of how Support at Home classifications and costs work, see our guide to home care services in Australia.
How to Access Palliative Care Services in Australia
The pathway to palliative care in Australia depends on the person’s age, eligibility, and the type of service they need. These are the main access routes.
Through Your GP
For most people, the GP is the first point of referral to specialist palliative care services. A GP can refer directly to a hospital-based palliative care consultation team, a community palliative care service, or a home-based palliative nursing service. GPs can also initiate the End-of-Life Pathway Form for Support at Home participants. Asking your GP directly about palliative care does not mean giving up on treatment. It means adding another layer of support.
Through My Aged Care
For older Australians, palliative care and end-of-life support within the aged care system is accessed through My Aged Care on 1800 200 422 or at myagedcare.gov.au. The End-of-Life Pathway specifically requires an aged care assessment to confirm eligibility. My Aged Care can also help connect families with state and territory specialist palliative care services.
Through State and Territory Services
Each state and territory in Australia has its own specialist palliative care system, typically delivered through public hospitals and community health services. These services operate independently of the aged care funding system and can be accessed by people of any age with a life-limiting illness. Contact your local hospital or call Palliative Care Australia’s national directory at palliativecare.org.au for state-specific services.
For NDIS Participants
For people under 65 on the NDIS, NDIS providers can include nursing and personal care supports in a plan. Contact your NDIS support coordinator or the NDIS directly on 1800 800 110 to discuss what can be included in your plan for end-of-life support.
How Tenax Supports Helps at Every Phase of Palliative Care
Tenax Supports is a registered home care and palliative care provider delivering services across [insert service regions]. Our clinical team includes AHPRA-registered nurses experienced in community-based palliative care, and our support workers are trained in end-of-life care delivery with appropriate supervision and protocols in place.
We can provide support across all five phases, from establishing early care routines during the stable phase, through to intensive nursing and personal care in the deteriorating and terminal phases, and connecting families with bereavement support resources after a death. We work alongside GP and specialist palliative care teams rather than replacing them, and we coordinate directly with My Aged Care to support access to the End-of-Life Pathway when eligibility is triggered.
We also work across both the Support at Home program and the NDIS, meaning we can support people at different life stages without requiring a change of provider. If a family is navigating the question of which program applies, our team can help clarify that and connect with the right pathway. For an introduction to the broader system of Australian home care and aged care agencies, see our guide to choosing an Australian home nursing and aged care agency.
If you are supporting someone through any phase of palliative care and want to discuss what additional help is available, we offer a no-obligation consultation. Contact our team and we will be in touch to talk through your situation with no pressure.
Understanding the Phases Is the First Step to Better Care
The five palliative care phases are a framework for communication and care planning, not a script for how someone’s illness will unfold. Understanding what each phase involves, how they typically progress in Australia, and what care and funding is available at each point, helps families make better decisions at a time when clear thinking is genuinely difficult. The most important single action most families can take is to engage with palliative care services earlier than they think they need to. Earlier referral means better symptom management, more time for planning, and a greater likelihood that the person’s wishes about where and how they want to be cared for can actually be honoured. If you need help knowing where to start, reach out to Tenax Supports for a conversation.
Frequently Asked Questions
What are the 5 phases of palliative care in Australia?
The five PCOC palliative care phases are: Stable (illness managed, care plan working), Unstable (sudden change requiring urgent review), Deteriorating (gradual ongoing decline with increasing needs), Terminal (final days to weeks of life), and Bereavement (support for family and carers after death). The framework was developed by the Australian Association for Hospice and Palliative Care in 1993 and is now used nationally to benchmark and improve palliative care quality.
Do the palliative care phases happen in order?
No. The phases are not a fixed sequence. A person can move between phases in any direction, return to an earlier phase, or remain in one phase for an extended period. AIHW data shows patients in inpatient settings have an average of 2.4 phases per episode of care. Phases change when the existing care plan is no longer meeting the person’s needs, not on a predetermined schedule.
How long does each palliative care phase last?
Based on AIHW 2024 data, average phase duration is 3 times longer in community settings (11.1 days) than inpatient settings (3.6 days). Stable phases average 23 days in community care. Deteriorating phases average 15 days. These are population averages and individual experience varies considerably depending on diagnosis and circumstances.
What is the difference between palliative care and end-of-life care?
Palliative care can begin at any point after a serious illness diagnosis and focuses on quality of life, symptom management, and holistic support for the person and family. End-of-life care refers specifically to care in the terminal and bereavement phases. In Australia, a person can receive palliative care for months or years before reaching the terminal phase. Early palliative care referral is consistently associated with better outcomes.
Can palliative care be delivered at home in Australia?
Yes. Community-based palliative care at home is available through state and territory services, NDIS providers, and Support at Home registered providers including Tenax Supports. The Support at Home End-of-Life Pathway provides up to $25,000 over 12 to 16 weeks for eligible older Australians wanting to remain at home in their final weeks. Clinical palliative care services (nursing, allied health) are fully funded under Support at Home with no participant contribution.
What is the Support at Home End-of-Life Pathway?
Available from 1 November 2025, the End-of-Life Pathway provides up to $25,000 over 12 weeks (extendable to 16) for eligible older Australians with a prognosis of three months or less and an AKPS score of 40 or below. Eligibility is confirmed by a doctor or nurse practitioner. The pathway is accessed through My Aged Care and bypasses normal waiting lists. It funds nursing, personal care, domestic assistance, and other in-home supports alongside existing state palliative care services.
What bereavement support is available in Australia after someone dies?
Key bereavement support services in Australia include Griefline (1300 845 745, free confidential counselling), Carer Gateway (1800 422 737), Beyond Blue (1300 22 4636), and Lifeline (13 11 14). Local hospital palliative care teams also offer bereavement follow-up. Palliative Care Australia at palliativecare.org.au can connect families with state-based services. Most palliative care services make contact with families within the first week after a death.