End-of-life care covers the physical, emotional and social needs of a person approaching the end of their life, providing support and treatment to help them live as well as possible in the time remaining.

End-of-life care usually includes:

• talking about and making plans for how you would like to be cared for at the end of your life, such as where you would like to die and your medical preferences – you might hear this referred to as advance care planning
• managing any physical symptoms, including pain relief
• emotional support for you and those close to you
• Helping you and your loved ones understand what to expect towards the end of your life
• helping you to die with dignity.

End-of-life care can also involve help with practical issues such as making a will, obtaining financial support for your care needs or planning your own funeral.

Once end-of-life care begins, your care team’s focus will be on ensuring that you have the best possible quality of life for the time remaining, rather than trying to cure you of any serious illness. Sometimes this is done by attempting to treat reversible problems, such as infection, and sometimes this is by focusing on managing the symptoms. You will be part of the decision making around what focus to take.

When does end-of-life care begin?

End-of-life care should begin when you need it and may last a few days, months or sometimes even years. It depends on your needs and the nature of your health conditions. 

Generally, people are considered to be approaching the end of life when they are likely to die within the next 12 months. This includes individuals who:

• are very close to death
• have an incurable illness at an advanced stage, such as cancer, dementia or motor neurone disease
• have existing conditions that put them at risk of dying from a sudden health crisis linked to their condition
• have suffered an accident, stroke or other life-threatening event.

Your healthcare team will decide when to start end-of-life care. They will do that in discussion with you, or those close to you if you’re not able to speak for yourself.

Once end-of-life care begins, doctors may decide to cease any medical treatments that are no longer beneficial. However, they should continue to review your condition regularly, looking for any signs that you may be stabilising or recovering, even temporarily.

Where can end-of-life care be delivered?

Depending on your needs and preferences, you may receive end-of-life care at home, in a hospice, in hospital or in a care home.

If you have particular wishes about how you’d like to be cared for at the end of life, the best way to make sure your wishes are followed is to talk to your doctor and those close to you in advance about what you’d like to happen. They can help you think through the options and work out how and where to get the support you need. 

If you then put your wishes in writing, everyone involved in your care will know what your preferences are, even if you can’t speak for yourself. For guidance on how to start recording your wishes, see our article on advance care planning.

Who is involved in delivering end-of-life care?

Various health and social care professionals can be involved in end-of-life care, depending on an individual’s needs. Some of these will be NHS health and care staff, such as doctors, nurses or physiotherapists, while others may belong to social care agencies, hospices or charities.

If you’re at home or in a care home, your GP will have overall responsibility for your care. Community nurses usually play a key role, and family and friends may also be closely involved.

Improving care of those approaching the end of their life is increasingly important in the world of health. The Royal College of GPs (RCGP) and Marie Curie have developed the Daffodil Standards – a set of voluntary guidelines to help GP practices improve care for patients approaching the end of life. GP surgeries displaying a daffodil sign are showing commitment to the scheme.

Five priorities for care at the end of life

Wherever you’re cared for, healthcare experts recommend that the professionals caring for you should observe the following priorities for care in the last days and hours of your life.

• A doctor should examine you regularly, and if they believe you are likely to die soon, they will explain this to you and to your loved ones.
• Healthcare staff should communicate in a sensitive and honest manner with you and the people close to you.
• You should be involved in any decisions about your care if you would like to be.
• The needs of your family and other people close to you should be met as far as possible.
• An individual care plan should be created, taking your preferences into consideration, and it should be carried out with compassion.

These exactly match our ways of caring for you here at Katharine House Hospice.

Related pages

• Choosing where to be cared for: you may prefer to be cared for at home or in a hospice or hospital; read about the benefits and disadvantages of being cared for at home.
• Financial support: there’s financial support available for people diagnosed with a life-limiting illness – find out if you or someone you are caring for are eligible.
• How we help: Katharine House Hospice provides end-of-life care in the community, at the hospice itself and in local hospitals, together with lymphoedema treatment, psychological and spiritual care, and social and bereavement support.

The EPiC Resource Centre is kindly sponsored by Cleenol: working for a cleaner, safer, kinder world.