End-of-life (EOL) care involves not just the final few days of a person’s life but also incorporates living with a terminal illness over an extended period of time. Importantly, in addition to medical care and relief of physical suffering, it focuses on quality of life, honoring personal healthcare treatment decisions, supporting the family, and psychological, cultural and spiritual concerns for dying people and their families. The goal of this commentary is to raise rehabilitation therapists’ awareness of the need for culturally safe EOL care services for First Nations persons who live on reserve and to identify strategies to help resolve this unmet need.