Choosing where you would like to spend your last days of life
It's important for people nearing the end of life to choose where they would like to be, and who they'd like to be with.
Most people with a terminal illness say they would like to die at home. This is not true for everyone, though, so it's important to find the right solution for each individual.
The NHS (the HSCNI in Northern Ireland ) is trying to give people choices about where to be during their last days.These include care homes and nursing care at home. But sometimes it's hard to understand all your options, who can help, and how the local system works.
Ask about your choices, and what's available locally. A district nurse, a specialist nurse who works in the hospital or visits at home, your Marie Curie Nurse or doctor can give you the information you need.
There is no rule that says a person must be in hospital at the end of life. You have several options:
You might want to be in your own home or the home of a friend or relative. It's possible to have expert nursing at home. Marie Curie Nurses and community nurses both offer this care.
Most people die in hospital. Sometimes this is through choice and sometimes because it's the way that things work out. It's also worth knowing that hospitals are the best place to be if you intend to donate your tissue or organs for transplant.
In a care home
You may already be living in a care home and might want to stay where you feel comfortable with your surroundings, the other residents and the staff. Or you might be considering moving into a care home.
In a hospice
Hospice care is focused on promoting a good quality of life, with kind and expert care, when someone has a terminal illness. The surroundings are home-like, but highly skilled doctors, nurses and other professionals are always on hand.
You can visit a hospice for day care, and depending on where you live you might be able to alternate between home and hospice as you need. Hospice care is free of charge. A hospice looks after your whole family, and is also there to support them after you die. There are Marie Curie Hospices around the UK. You might like to explore the Hospice UK website too.
When it's time to think about the best place to be at the end of your life, you choice will ideally be guided by what's most important to you as an individual. Of course, your condition can change as the illness progresses and therefore so can your decisions about care. This is perfectly reasonable and you'll have opportunities to discuss this with the team that looks after you.
Who to be with
When the end of life is coming, many people want to be with those they love most. This might be your partner or any member of your family. You might like to have friends coming and going freely. Having a much-loved pet nearby can also be very comforting.
Peace and privacy
A calm and pleasant environment can be very comforting during this emotional time. It helps you cope with the physical and mental changes you're facing. Privacy is important to protect your dignity and family and friends need it too.
Familiar home comforts
Whether it's resting in your own bed or having a few favourite photos in sight, being around familiar possessions is reassuring and helps you to simply be yourself.
Having the right care
Good medical and nursing care is essential to control any pain or symptoms you might have. Constant care is often needed near the end, as people become very weak. Having access to good care also makes everyone feel more secure, including family and friends.
Sometimes your emotions can seem overwhelming, and having kind and caring support with your feelings is as important as good care for your physical needs. This is true for family and friends as well.
You might find it comforting to talk to someone you don't know, such as a counsellor. Alternatively you could write down what you're feeling and thinking. Some people find meditation useful, regardless of whether they have any spiritual beliefs.
Facing death is likely to make you think about life's big questions. Spiritual support is an important part of end of life care and it can really help to talk to a thoughtful person who understands your difficulties. Anyone can ask for a faith leader, even if you're of a different faith or don't belong to any religion. They can visit you anywhere, whether that's at home, a care home, hospice or hospital.
With good communication and planning, and the right support, it should be possible to meet your needs, wherever you choose to be at the end of your life.
People often change their minds along the way, and that's fine. Making a choice now doesn't mean having to stick with it all the way through. If you feel different later on, or things don't go as expected, plans can always be changed.
When you've made these decisions about the end of your life, it's important to make your wishes known so that your choices can be respected when the time comes. Our section on planning ahead explains how to do this.
All Ireland Institute of Hospice and Palliative Care (AIIHPC) – for care in Northern Ireland
This content is provided for general information purposes only. It's not medical, financial, legal or personal advice. We suggest that you consult with a qualified professional about your individual circumstances. How our information is created and how it's used.
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