End-of-Life Care in US Nursing Homes

Updated 30 October 2026 · Educational resource

Many people spend their final months in a nursing home. Good end-of-life care in these settings includes pain and symptom management, respect for advance directives, emotional and spiritual support, and clear communication with families. Facilities are expected to honor residents’ wishes regarding life-sustaining treatment and to coordinate with hospice when appropriate.

Key components

• Advance care planning and documentation of goals of care
• Access to hospice services for eligible residents
• Comfort-focused interventions for pain, shortness of breath, and anxiety
• Family presence and support during the dying process
• Staff training in palliative and end-of-life care

Residents have the right to refuse treatment and to have their advance directives followed. Families should ensure that current wishes are documented and that the facility has copies of any living will, durable power of attorney for healthcare, or POLST/MOLST form. State laws govern the exact forms and processes.

Disclaimer: End-of-life decisions are personal and should be made with healthcare providers and, when desired, spiritual advisors. This page is general information only.

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