Comfort care at home: what it is and how to arrange it

Comfort care at home means looking after someone with a life-limiting illness so that they are as free as possible from pain and distress, in their own surroundings. It is not a separate NHS service. You arrange it through the GP and district nurses, who can bring in specialist palliative care, a hospice team, social care and equipment.

At a glance

• “Comfort care” is an everyday phrase. The NHS describes the approach as palliative care and end of life care.
• At home or in a care home, the GP has overall responsibility, and community nurses usually visit.
• NICE says people nearing the end of life should have 24-hour access to a healthcare professional, an advice line and medicines for symptom control.
• Anticipatory (“just in case”) medicines can be prescribed in advance so symptoms are treated quickly.
• If someone is rapidly deteriorating, a clinician can request fast-track NHS continuing healthcare funding.

What does comfort care at home mean?

The NHS explains that palliative care aims to make someone as comfortable as possible by managing pain and other distressing symptoms, and that it also covers psychological, social and spiritual support for the person and their family. It can start when a life-limiting illness is diagnosed and can run alongside treatments aimed at the condition itself.

End of life care is the part of palliative care for people close to the end of life. The NHS treats someone as approaching the end of life when they are likely to die within the next 12 months, although it is not always possible to predict. This includes people with advanced cancer, dementia or motor neurone disease, people who are frail with other conditions, and people who could die if an existing condition suddenly worsens.

Our guides on palliative care and end of life care and palliative care at home explain the terms in more detail. For the fuller picture of arranging help, see end of life care at home.

Who provides comfort care at home?

Several people share the work, and the family is often closely involved.

• The GP has overall responsibility for care at home, and can arrange community nurses to visit.
• Community palliative care nurses can provide or arrange hands-on nursing and personal care, advise on pain and symptom control, and support family carers.
• Specialist palliative care teams include doctors, nurses and therapists who advise other professionals and co-ordinate care for incurable illness.
• Hospice and charity nurses, such as Marie Curie Nurses in some areas, can be referred through the GP or district nurse.
• Social care can provide carers, equipment and adaptations such as hand rails through the council. See social services care packages.

Ask the GP who your named contact is, and write down their number. NICE guidance on end of life services recommends that the people involved should be clear about who the team members are and how to reach them.

What does comfort care involve day to day?

The focus is on the person’s comfort, dignity and wishes. The detail depends on the illness, but commonly includes:

• Pain relief. Not everyone has pain. If they do, the doctor or nurse will assess it and choose the weakest medicine that keeps the person comfortable. This can be by mouth, a skin patch or injection, or a small pump called a syringe driver if swallowing becomes difficult. Where someone cannot say they are in pain, such as with advanced dementia, signs like grimacing or groaning are used, and NICE recommends a validated behavioural pain tool.
• Managing other symptoms. Sickness, constipation, breathlessness and loss of appetite can all be treated. Ask the nurse about small, frequent snacks and sips, or dry foods such as toast.
• Eating and drinking. Towards the end of life the body cannot digest food well. The NHS says relatives do not need to make someone eat. NICE advises frequent mouth and lip care, help cleaning teeth or dentures, and frequent sips for as long as the person wishes.
• Warmth and skin. Hands and feet can feel cold as circulation changes, and blankets help. Nurses can advise on changing position to protect the skin; see pressure ulcers.
• Personal care and dignity. Washing, continence care and moving need gentle help. See dignity in personal care.
• Emotional and spiritual support for the person and for the family, including time with chaplains of any faith or none if wanted.

The NHS also describes changes in the last hours and days: more drowsiness, irregular or noisy breathing, and sometimes confusion or restlessness. The medical team can look for causes such as pain or infection, and there are medicines that can ease distress. Our guide to the signs of end of life covers this in more detail.

What are anticipatory (“just in case”) medicines?

Marie Curie explains that anticipatory medicines, also called just in case or end of life medicines, are prescribed in advance in case sudden symptoms appear, so they can be given quickly. They are usually injections, supplied with needles and syringes, and used for pain, breathlessness, nausea and vomiting, agitation or restlessness, and noisy breathing. Not everyone develops these symptoms.

A district nurse will usually give them. If symptoms start, call the GP, specialist nurse or district nurse, who will guide you. NICE recommends prescribing suitable anticipatory medicines as early as possible and reviewing them as needs change.

The GP usually prescribes enough for a few days and reviews within a couple of days. Not every pharmacy stocks them, so ask the GP or nurse which local pharmacies do. Keep the medicines in a cool, dry place out of reach of children, as instructed.

Who do you call at night or at the weekend?

NICE says adults approaching the end of life, and their carers, should have access to a healthcare professional 24 hours a day, 7 days a week, an out-of-hours advice line, and an out-of-hours pharmacy with access to symptom control medicines. What exists varies by area, so ask before you need it.

• In England, Scotland and Wales, NHS 111 is open 24 hours a day and can arrange a nurse, GP or home visit.
• In Northern Ireland, there is no 111 service; call the GP surgery to be directed to out-of-hours care.
• Some hospices and palliative care teams have a 24-hour number. Keep it by the phone.
• Call 999 in a life-threatening emergency.

When a death at home is expected, a trained healthcare professional has to verify it. Call the GP practice or the nurse named in the care plan, and out of hours the practice will give you a number to ring. Keep any DNACPR form or advance decision where visitors and paramedics can find it.

How is comfort care at home paid for?

NHS care, including hospice care, is free. Social care at home, such as carers who help with washing and meals, may involve a care needs assessment and a financial assessment. If someone has a rapidly deteriorating condition that may mean they are entering a terminal phase, a clinician can complete the NHS fast-track pathway tool to arrange NHS continuing healthcare without waiting for the usual assessment. See fast-track continuing healthcare and NHS continuing healthcare at home.

Benefits can also be claimed more quickly. Under the special rules for end of life, a person who has reached State Pension age and whose doctor says they may have 12 months or less to live can get Attendance Allowance at the higher rate of £114.60 a week, with no face-to-face assessment. A medical professional completes an SR1 form. Scotland has different rules. Read the Attendance Allowance guide, and ask about a carer’s assessment for the family carers.

Frequently asked questions

Is comfort care the same as hospice care?

No. Comfort care describes a focus on easing symptoms. Hospice care is a style of palliative care that can be provided at home, in a care home or in a hospice building. A hospice team can be part of comfort care at home.

Does comfort care mean stopping all treatment?

Not necessarily. The NHS says palliative care can be given while someone still has treatment for their condition. Reviewing which treatments still help is part of good care, and decisions are made with the person, their family and the clinicians.

Will the person be in pain at the end of life?

Not always. The NHS says not everyone approaching the end of life has pain. If they do, the doctor or nurse assesses it and chooses a suitable medicine and dose, and can use signs such as grimacing if the person cannot speak.

Can someone with dementia have comfort care at home?

Yes. The NHS lists dementia among the advanced incurable illnesses where end of life care applies. Staff should use a behavioural pain assessment if the person cannot describe pain. See continuing healthcare for dementia.

What if the family cannot manage at home any longer?

Tell the GP or district nurse early. Options include a short hospice stay for symptom control or a break, extra carers, or a move to a care home or hospital if the person agrees. Marie Curie advises having a back-up plan.

Where to get help next

Speak to the GP or call the number your healthcare team has given you. Marie Curie runs a free Support Line on 0800 090 2309. For benefits, try the Attendance Allowance checker; for funding, the NHS continuing healthcare checker. If you need paid carers, search home care on The Care Panel. Our guides to hospice care at home and bereavement support for carers may also help.

Sources

• NHS: What end of life care involves
• NHS: End of life care at home
• NHS: Changes in the last hours and days of life
• NICE NG31: Care of dying adults in the last days of life
• NICE NG142: End of life care for adults, service delivery and organisation
• Marie Curie: Just in case medications
• GOV.UK: Claiming Attendance Allowance if you are nearing the end of life

New guides: Hospital Bed at Home: Loans, Buying and Bed Rail Safety

Reviewed by The Care Panel team on 9 November 2026. This guide is general information about care in England, not legal, medical or financial advice. Rules and rates change; check with your council or an adviser before making decisions.