Choosing where to die

As your illness progresses, your day-to-day life and the kind of support you need may change. It can be helpful to think about where you'd like to be cared for in the future and in your final days. Telling people your preferences and planning ahead makes it more likely they can understand and follow your wishes.

This page is for people living with a terminal illness, and their family and friends.

On this page:

Thinking about your priorities

You may want to think about what's important to you and how the place you'd like to be cared for will affect those things. Everyone is different, so what's important for one person might be less important for someone else. It can help to look into your options and discuss these with the people important to you early on, so that they know what your preferences are. You might change your mind about where you want to be cared for over time - and that's OK too.

Your health and social care professionals should try to support your preferences about where you would like to be cared for. These professionals may include your GP, district or community nurse, social services or hospital doctor.

It's not always possible to provide the care you need in the place that you'd like. For example, if your symptoms are not being managed, you may need specialist care in a hospital or hospice. And if you need a lot of personal care, you may benefit from being in a care home.

Getting the right care for you

You may need different types of care:

• Medical or nursing care – this can help with things like having tests, managing symptoms, getting and taking medications.
• Personal care - this can help with things like washing, eating, getting dressed and going to the toilet.
• Social care – this includes personal care, and can also help with having meals delivered, getting equipment for your home, and looking at care homes if needed.

Wherever you are, it's important that you and any family or friends you have feel supported.

Being free from pain and discomfort

For many people, being free from pain and discomfort is an important factor when deciding where to be cared for. Not everyone will have pain towards the end of life. If you do, sometimes pain and discomfort can be managed well at home or in a care home. Some people might need specialist care in a hospice or hospital to manage their pain effectively. You can talk to your GP about what options there are for you and the best way to manage any pain.

Read more about pain at the end of life.

People important to you

Many people want to be with the people they love most or feel comfortable with. This might be family, a partner or friends. This might be especially important for you in your final days and you might like to have people visiting regularly. If you need to stay in a hospice, care home, or hospital, you can ask the staff about visitors.

If you'd like to live at home, it's important to think about the support that any family and friends would be able to give you. The support you need might change if your needs increase. You might need to talk to them about if they would be able to look after you at home. And you could look into what support might be available for them.

Being in familiar surroundings

Some people want to be in familiar surroundings, which often means being at home. If you're living somewhere else, it might be reassuring to take some of your possessions with you. Some people find familiar smells or textures comforting. You could take photos, bedding, perfume or clothes.

Having privacy

If you like privacy and space to yourself, you may prefer to be at home or in a care home. If you need to be in a hospice or hospital, you could ask if they have private rooms or rooms with other patients (bays). If you're in a room with others, you can draw your curtains. Or ask staff to try to not disturb you if you want some space or if you have visitors.

Help with personal care

If you become more weak and less able to move, you might need help with things like washing, eating, getting dressed and going to the toilet.

If you're at home, care workers may be able to help. But unless you're paying for private day and night care, they will not be there all of the time. It can help to think about whether a family member or friend could help with these things. Or whether you'd prefer to be in a setting where trusted staff can help, such as a hospice, hospital or care home.

If you do not have family or friends who can help

If you do not have family or friends who can help, or they do not live near you, it's important to think about who will support you. If you live at home, you might be happy to stay there. Or you might prefer to be somewhere with more help if you need it, such as a care home. You could speak with your local council or trust, GP, or district or community nurses about what support might be available.

Care at home

Some people prefer to die at home. This may be because they want to be in familiar surroundings, in their own space, and with the people important to them.

If you need care from health and social care professionals at home, speak to your GP about what care can be arranged for you. Your GP may involve a district or community nurse, who can organize and coordinate your care at home. This might include end of life care at home services, such as Marie Curie hospice at home services. Read more about end of life care.

Your local social services can help with social and personal care, such as support with:

• getting dressed
• washing
• eating
• taking medication
• making adaptations or getting equipment for your home.

If you do access social and personal care, the care worker will visit you at your home at arranged times. They will not stay with you all of the time. The maximum they can visit you is often four visits a day.

Find out more about how to get personal and nursing care at home.

If a family member or friend is caring for you, it's important to think about whether they're able to give you all the care you want or need. They might find this challenging. You could speak to them about how they are finding helping you and whether they'd be able to support you more if you needed it.

They can have a Carer's Assessment (called an Adult Carer Support Plan in Scotland). This will assess the needs they have as a carer and look at what support they might need.

Paying for care at home

Healthcare is provided free across the UK. But the level of care available depends on your needs and what's available in your area.

You may have to pay for some or all of your social or personal care – this can depend on where you live and how much money you have.

If you need more care than what's available, you could consider paying for care privately. Or looking into other options of where to be cared for.

Read more about how to get personal and nursing care at home, including any costs.

Hospice care

Hospices provide palliative care and end of life care. Usually people stay in the hospice if they need a high level of expert care to help manage their symptoms – not everyone can stay in a hospice.

Some people think that people only go to a hospice to die, but this is not necessarily true. Many people stay in a hospice when they need help managing symptoms, as they provide specialist care. Hospices can provide care for people with a terminal illness, sometimes from the time they receive a terminal diagnosis. As well as medical and nursing care, they provide emotional, practical and spiritual support.

Some hospices also provide care in people's homes or day services where you can visit the hospice. You do not need to stay in a hospice to access their support.

Hospice care is free, so you do not have to pay for it.

You can contact your local hospice or ask your GP to refer you to a hospice.

Find out more about hospice care.

Find your local hospice on the Hospice UK website.  

Hospital care

If you become unwell or need tests or treatment, you may need to go into hospital. Some people are referred to hospital by their doctor or nurse. Other people need to go into hospital in an emergency.

Decisions about your care might be made by staff in Accident and Emergency (A&E) when you arrive in hospital. You might then be referred to another ward or unit. Or you might go home.

Some hospitals have specialised palliative care units, sometimes called Supportive Care departments. They might also have a specialist palliative care team who work alongside hospital staff on a different ward. The staff will help to control your symptoms. They can also provide emotional support and information for you and the people important to you.

Sometimes, after staying in hospital, it might be difficult to organise the care you need at home. Health and social care professionals may suggest going to a hospice or care home. It can help to tell people what your priorities are and ask them what your options are.

Care homes

You may be cared for in a residential care home or nursing home if you can no longer manage in your own home.

In a care home, staff will help to look after you day and night in a homely setting.

In a care home, the staff are professional carers, but they're not nurses. They can provide help with things like washing, dressing and providing meals. If you need medical care, the GP and district or community nurses can provide this. Care homes usually offer long-stay care, but they may also offer short-stay or respite care to support those caring for you. Read more information about respite care and taking a break.

A nursing home (sometimes called a care home with nursing) has trained nurses on duty. If your health means you need nursing care on a frequent basis, then this type of home may be more suitable for you. Your GP can still look after your medical needs.

To find out what residential care is available in your area, speak to your health and social care professionals. It can take time to organise residential care and any decisions you make may be something you'd like to include in your advance care plan. Read more about planning your care in advance.

Some people living in a care home want to move to their home, a family member or friend's home or a hospice. Speak to your GP, district or community nurse or social services to find out what your options might be. Ask your family members or friends if they'd be able to provide more support if you were able to move home or to live with them.

Paying for residential care homes and nursing homes

Most people will be expected to pay something towards their care home or nursing home. This might depend on your healthcare needs, where you live and how much money you have.

Your local social services team in your council or trust can assess your needs and your finances and work out how much you might need to pay. Read more information about how to get social care and support.

If you live in England and Wales and have a complex healthcare need, you may be able to get care for free under NHS Continuing Healthcare – this can include paying for some of your care home fees. Read more about getting NHS Continuing Healthcare fast tracked at the end of life.

In your final days

It can be helpful to think about where you would like to die and what care you might need. In your final days, you might become weaker and spend more time in bed. And you might need help with symptoms like pain or feeling sick (nausea). If family or friends are helping with care, they might find it more challenging. Some people need more support than their family or friends are able to offer.

Many people die in the place where they want to be. Some people die at home with support from family or friends, or professionals who can help with their care. It's not always possible to provide the care and support that people need at home. It can be helpful to look at options in advance by visiting local hospices or care homes. This might help you decide where you would prefer to be cared for if you need more support.

It can take time to arrange somewhere for you to stay, and there is not always space when people need it. To find out what options are available in your area, speak to your GP, district or community nurse, social worker, or palliative care team. You can also call our free Support Line to talk things through on 0800 090 2309 or email support@mariecurie.org.uk

Making a decision

It can be helpful to think about:

• What makes you feel happy or comfortable?
• Have you thought about where you'd prefer to spend your final days and what support you'd need to do that?
• Will you have any specific care needs due to your illness?
• What options are available locally?
• How might any family members or friends be able to help?
• If you need to go to a care home, hospice or hospital, what is important to you? Who do you want to visit? What food and drink would you like to be offered?

If you're not sure where you want to be cared for, it might be helpful to speak to:

• friends, family, or anyone else in your support network
• your GP
• any health and social care professionals involved in your care.

Read more about planning your care in advance.

Telling people about your preferences

It's important to tell your friends, family, and health and social care professionals what your preferences are. They can help you plan your care.

It can be difficult to have these conversations. You may be concerned about upsetting or worrying your family or friends. It can help to plan what you want to say, choose a place and time that you feel comfortable, and try to speak honestly.

If you're not sure how to approach this, you can get help from our free Support Line on 0800 090 2309 or email support@mariecurie.org.uk

You can also make a record of where you'd like to be cared for in your advance care plan. This means that if you are not able to make or express your own decisions in the future, the people looking after you will know what you'd like.

Read more information about making an advance care plan.

Changing your mind

Some people change their mind about where they'd like to be cared for. This might be because their needs have changed, or their situation has changed. It's OK to change your mind. Telling people what you want now does not mean you have to stick with it. If you feel differently or things do not go as expected, plans can be changed. Let your family, friends, and health and social care professionals know so that they can try their best to support your preferences.