BACKGROUND: Families living with a dying relative face existential challenges which need to be met by caregivers in a dialogue. AIM: To describe couples' experiences of participating in nurse-initiated health-promoting conversations about hope and suffering during home-based palliative care. METHOD: Data comprised semi-structured evaluative interviews with six couples. Each couple together had previously participated in three health-fostering conversations with nurses. Data were analyzed by content. RESULT: Talking with nurses about existential issues such as hope and suffering made couples feel that they were part of a trustful relationship, and that it was a healing experience. It gave them the opportunity to unburden themselves, as well as a way of learning and finding new strategies for managing daily life. CONCLUSION: Health-promoting conversations about hope and suffering should be implemented as a natural part of the caring relationship between caregivers and families in the palliative context.