Your choice of where to live and be looked after will probably depend on a number of factors, such as:
- whether you have an illness that you need help from medical staff or care workers to manage
- what support you would have if you stayed in your own home - for example, from friends, family or care workers
- availability in your area, for example of hospice services or care home spaces
- where you are currently living.
Talk to your GP and people you trust about your preferences and what might be possible. Ask your GP to record your wishes, or write an advance statement, so that professionals involved in your care are aware of what you would want.
Many people wish to spend the end of their life in their own home. The familiar surroundings can provide comfort and help you to feel in control. If you require more care than family and friends are willing or able to give, it might be possible to receive services at home. If you might need help from visiting palliative care nurses or district nurses, speak to your GP about what is available in your area. If you need help with personal care, ask your local council’s adult social services team for a free care needs assessment. Making adaptations to your home could also enable you to stay there.
Up until three years ago, my mother could go up and down stairs at my home and the realisation that she couldn’t do this anymore was a real watershed moment. We brought a bed from upstairs and made a room for her downstairs. It isn’t ideal though, as we only have a small downstairs cloakroom, so we’re now looking at adapting downstairs to get a small en suite wet room for her.
Some people may choose to remain at home, but as their illness progresses find that this isn’t possible and they would actually rather be supported in a hospice, hospital or care home.
In a hospice
Hospice care is for people living with terminal or life-limiting illnesses. Hospices focus on caring for people as individuals, and looking after their emotional needs and wellbeing as well as their medical needs. They provide a range of services, including counselling, psychological and spiritual support, practical advice, and pain management.
I think the whole environment of the hospice movement is about openness, about talking about it, and recognising and coming to terms with it.
If you move into a hospice, this will usually be in the last two weeks of your life. Hospice care can also sometimes be provided to people in their own homes or in a care home. Hospice care is always free. Ask your GP or a local hospice for information or visit hospiceuk.org.
In a care home
If you’re already living in a care home, you may want to spend the end of your life in a familiar place. You might also be able to move to a care home for a short period before you die, although bear in mind that care homes may have waiting lists and they can be expensive. Speak to your local council’s adult social services team and ask for a free care needs assessment to be carried out before you move into a care home. You may be entitled to help with funding from your local council or the NHS. You can search for care homes on the Care Quality Commission website.
The end-of-life care offered by care homes varies. Some will have their own end-of-life teams and others may use visiting services, for example from a hospice.
Many people will spend the end of their life in hospital. It may seem less comforting than being in your own home, but some people will find it reassuring that staff have the expertise to care for them and relieve their pain and symptoms where possible. Some hospitals will have specialist palliative care teams.
If you want to donate your organs, this is only possible if you die in hospital.
Read our guide Planning for the end of life