Nursing homes have taken on more and more the character of a hospice where palliative competence has significantly become more important. The aim of palliative treatment is not to heal but to control the symptoms during the final stage. The treatment of pain is definitely the main priority. Diagnosing and estimating the severity of the pain are basic requirements of an effective analgesic treatment. In addition to the pain, there are other symptoms such as nausea and emesis, dyspnoea, death rattle,fear, delirium and obstipation in the final stages of a disease which should be controlled very carefully. Not only patients suffering from cancer, but also very sick multimorbide patients and those suffering from dementia in geriatric environments will profit from palliative care.