Marie Curie said one in five hospital beds in Wales were occupied by people in the last year of their lives and "bold, radical" action was needed for services which were at "breaking point".
One family said they had to fight to ensure their 85-year-old father could die peacefully at home rather than in a hospital ward.
The Welsh government said it provided more than £16m a year to ensure people had access to the best possible end-of-life care.
Marie Curie said gaps in care meant "too many people are spending their final days isolated, in pain, and struggling to make ends meet".
"End-of-life care in Wales is at breaking point," said Senior Policy Manager Natasha Davies.
"Services and staff are struggling to deliver the care people need, when and where they need it. There is an urgent need for change."
The charity recognised while hospital was the best place for many palliative care patients, better community and out-of-hours care would allow people to be cared for in their homes.
"It also means having meaningful conversations with dying people about their care preferences, so their wishes are heard and respected," added Ms Davies.
The Welsh government said good palliative and end-of-life care could make a "huge difference" to helping people die with dignity.
Source: BBC News, 2 June 2025
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