Temel et al., 2010). No palliative care or late initiation can lead to suboptimal care in the final months of life (Higginson et al., 2014). Studies focusing on palliative care initiation frequently do so from a health service or professional carer perspective. Late recognition of palliative care needs (Beernaert et al., 2016) or late referral (Temel et al., 2010) by the professional carer (Bakitas et al., 2009; Dionne-Odom et al., 2015) are examples of factors hindering timely initiation of palliative care. These studies also showed that adequate and timely communication about palliative care is important for initiation (Horlait, Chambaere, Pardon, Deliens, & Belle, 2016), but there is room for improvement (Bauman & Temel, 2014). Initial palliative care discussions often seem to be postponed or avoided