Choosing where to die

The choice of where you will die often depends on:

  • what you would like
  • what help you have from family and friends
  • the services available where you live
  • your medical condition.

Wherever you are cared for, it is important that your symptoms are well managed and you get the care you need. This can happen in different places.

At home

You might prefer to die at home, if you know you will have good quality care. Even if you choose not to, you can still be surrounded by people and things that are important to you.

Staying at home allows you to be in a familiar place, with close family members or friends to look after you. It may help you feel more in control. It may also make it easier for you to say goodbye to people you love.

It is important that you and your carers have as much support as possible. There are people and organisations that can help you manage any symptoms and support you and your carers at home. If you would like to die at home, tell your GP, cancer doctor or nurse.

Hospice

Hospices specialise in caring for people who have a terminal illness and may be close to the end of their life.

They have doctors and specialist palliative care nurses who are experts in controlling symptoms such as pain. They also provide emotional support. Many hospices have nurses and healthcare assistants who can visit and help care for people at home.

You can go into a hospice for different reasons. For example, you may stay there for a short time to get your symptoms under control. Some hospices offer respite care. This means you can go in for a short time to give your carer a break. Your palliative care team can tell you what is available at your local hospice.

You may decide that you would like to die in a hospice. You will need to discuss your wishes with your family, your GP and the hospice team involved with your care.

Hospices are very different to hospitals. They are quieter and provide care to suit each person’s situation. Visiting is usually less restricted than in a hospital. They may offer a wide range of services for patients and their families. These may include:

  • counselling
  • spiritual care
  • complementary therapies
  • psychological support
  • bereavement support.

Accommodation and care in a hospice is always free of charge. Each hospice has a limited number of beds. There may be a waiting list, but urgent admissions can sometimes be arranged within a couple of days. It can help to talk to your GP and palliative care team to try and plan ahead.

Some hospices have outpatient services or day centres. If you are living at home, you can visit the day centre for a day or more each week. You can get care from the specialist team and support from other people who are living with similar illnesses.

If you are not sure about hospice care, you can ask to visit the hospice. The staff will be able to show you around and talk through any questions or concerns you have.

You can find out more about your local hospice from your GP, district nurse or palliative care nurse. Hospice UK also has useful information about hospices and where they are across the UK.

Residential homes or care homes with nursing

If you might need care for several months, you may prefer to be looked after in a residential care home or care home with nursing (nursing home). A care home with nursing has qualified nurses on their staff to provide nursing care. They usually offer short-stay or long-stay care.

You may still be able to go to the hospice for day care. Or a specialist nurse from a hospice may be able to visit you in the care home.

Your GP or healthcare team can explain the different types of care homes. They may be:

  • privately owned
  • run by a charity
  • run by the local council.

A private care home charges a fee for care. But you can sometimes get help with paying this if you have few or no savings.

You may be able to get NHS funding for your care in a care home with nursing. For example, this may be if you are reaching the end stages of your illness, or if you need a lot of nursing care and support. A hospital nurse, district nurse, hospice nurse or social worker can tell you more about fully-funded care. If you live in Northern Ireland, funding for care homes is based on your income (means-tested).

NHS UK has information about care homes and funding for care. You can get lists of local registered care homes and details of registered care homes with nursing from your local social services department and your area health authority. You can also search for a care home by visiting carehome.co.uk.

Hospital

If you have been in and out of hospital over the last few months, you may want to go back to your usual hospital ward when you need full-time nursing care. This might be easier to arrange if you have been in a small local hospital (for example, a cottage hospital) rather than in a district general or teaching hospital.

Although many people die in hospital, it may not be the most peaceful place to be if the ward is busy. Often you will need to fit into the ward routine, rather than being looked after in the way that you would like.

Hospitals have palliative care teams that include specialist nurses and doctors. A specialist nurse or doctor from this team may be able to see you while you are in hospital. They can help manage your symptoms and offer you and your family emotional support.

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