Many people will want to die at home, in their own bed, surrounded by their close family. However, this may not always be possible, or practical. About 1 in 5 people with cancer in the UK chose to die at home, and this is usually possible if you have family or friends who can care for you. There are support services to help families look after a person dying at home.

At this time, good nursing care, emotional support and the skills of people trained to help with your symptoms will be very important. It may be important to you to be surrounded by people and possessions which are dear to you. This can happen in a variety of places, not just at home.

You may hear the doctors or nurses who are providing your care, or that of a loved one, talking about the Liverpool Care Pathway. The Liverpool Care Pathway is a care pathway for people who are dying. Care pathways are plans of how someone should be looked after when they have a particular medical condition or set of symptoms. The idea behind the pathway is to make sure that people get the same high standard of care, with all their special needs attended too, whether they are dying in a hospice, at home, in hospital or in a care home.

Often the choice of where you will die is a compromise between what you want and what is possible.

If you are a carer reading this, it’s important that you don’t feel guilty if you encourage your partner or relative to die in a hospice, hospital or nursing home. If you have to make the decision to move them at a late stage, then this shouldn’t be seen as a failure, but rather because you want to make sure that your loved one gets the expert care that they need at this time.

If home is where you want to be, it’s essential that you and your carers have as much support as possible. Caring can be hard work, both physically and emotionally. It’s not always easy to ask for help, and many people find it impossible. However, it is important that your carers save enough energy to do the things that only they can do, such as spending time talking to you and supporting you. They can pass on some jobs to other people, where possible.

Your GP, district or community nurses, specialist nurses and home care teams from the local hospital or hospice can tell you about other types of help and support. If you need a commode, bedpan, bottle, special mattress or incontinence sheets then ask your district nurse. You may need to rearrange your home: for example make a dining room into a bedroom - so that the person can be cared for on the ground floor and does not have to cope with stairs.

Details of all these services are available in our section coping with advanced cancer.

Care at night (nurses or night sitters) may be available in your area. Volunteers from local organisations may be available to sit with you while your carer shops, or they may be able to do the shopping.

You can make an appointment with your GP or the hospice home care team to talk through what may happen and make a plan for dealing with emergencies which may occur.

You need to know how to reach the district nurses or out-of-hours doctor. If you’re being looked after by the hospice home-care nurses, you need to know how to contact them in the middle of the night or at weekends. This should enable you to sort out most problems that occur at home.

We have further information that can help you understand what happens at this difficult time and reduce some of the fear and uncertainty. Our free booklet, End of Life: The Facts, aims to support patients, families and carers in caring for the terminally ill at home. Developed in conjunction with Marie Curie Cancer Care, you can find an online version of it here: www.mariecurie.org.uk/endoflife. You can also order a copy of the booklet from Cancerbackup.

Hospices are places which specialise in the care of people living and dying with chronic illness. They can offer a wide range of services such as complementary therapies, counselling, spiritual care, and bereavement support. They are expert at controlling pain and other symptoms and also supporting the patient and their family. Their philosophy is to enable dying people to live in physical and emotional comfort with personal dignity until their death.

Hospices are smaller and quieter than hospitals and decorated in a more home-like way. They can tailor their care to suit each person and have a gentle atmosphere. People can often go into hospices for short periods for their symptoms to be monitored or to give their carer a break. This is known as respite care.

There are now more than 200 hospices in the UK. Many have home-care teams and day centres for people living at home. Some are funded by charity and some are part of the NHS. Care in a hospice is always free. You can find out more about your local hospice from your GP or palliative care or symptom control nurse (sometimes called Macmillan nurses) or Marie Curie nurse. Hospice Information also provide details of services.

If you will need an extended period of basic nursing care, a nursing home is likely to be more appropriate. You may still be able to go to the hospice for day care, or the nurses from the hospice may be able to visit you in the nursing home.

Private nursing homes usually offer short-stay or long-stay care. Your GP, district nurse or social worker can arrange this for you, but it may take some time. A fee is charged for care in private nursing homes, although you can sometimes get help in paying for this if you have little or no savings.

Lists of local registered care homes and details of registered nursing homes are available from your local social services department and your area health authority. You can get information about finding a nursing home and all the issues to consider on the Nursing Home Fees Agency website at www.nhfa.co.uk

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. However, this may be difficult to organise if the ward is very busy.

Many people die in hospital, but a busy medical or surgical ward may not be the most peaceful place. Often you may need to fit into the ward routine, rather than being able to be looked after in the way that you would like. However, some hospitals have special symptom control wards (palliative care units) where care is more personalised.