Speech-language pathologists (SLPs) provide services to patients confronting the end of life (EOL) in a variety of settings. Instead of targeting improvement of health or sustaining life, EOL services focus primarily on quality of life. Although SLPs may not consider themselves core members of the health care team providing EOL services, the ability to communicate during the final days of life can be as important as pain relief. Awareness both of the factors that influence individual and family responses to a terminal diagnosis and of the stages in the progression toward death helps the SLP make appropriate and realistic recommendations regarding communication and swallowing, counsel family members, and inform other health care professionals.