This qualitative study, conducted in three metropolitan areas, Champagne Ardenne, Ile-de-France, and Languedoc-Roussillon explores current palliative care practices in 37 facilities, both for dependent elderly (nursing homes) and for adults and children with severe disabilities (MAS and IME). The study confronts the viewpoints of the different actors that revolve around a patient: doctors, nurses and other health professionals (physiotherapists, occupational therapists, psychologists, etc.), relatives, volunteers and patients themselves. 40 cases of sick children and adults were observed. From the analysis of the interviews, it appears that the palliative approach is still not fully adopted by teams that are reluctant to deal with the end of life and postpone the most difficult cases. Among the priorities to be developed are: the harmonization of the initial training of caregivers and ongoing training and the mobilization of specialist palliative care that could better support and assist caregivers in this sector.