Choosing where to die can be hard to think about. But being in the right place for you can be really important when you know your life is coming to an end. Although your needs may change over time, most people find it helpful to think about what they would like before they become too ill.
Where to start?
The best thing is to talk it through with the people closest to you. You should also talk to your key healthcare worker – the person providing the care who knows you best. Together you can explore what is possible and realistic for you.
If you want to, you can record your preferences in an Advance Care Plan - so that everyone involved in your care is aware of your choices.
Often it is not a single decision, but different preferences you would have in different situations. For example, you may choose to stay at home as long as possible, but wish to go into a hospice in certain circumstances – such as if it is no longer possible to manage your symptoms at home, or if your family are struggling to cope.
When do you have to decide?
Choosing where to die can be very hard to think and talk about, and there is no right or wrong time to choose. You can take the time you need and decide when you are ready.
Sometimes your condition may change suddenly, and then your healthcare team might encourage you to make a decision so that they know your wishes.
After you have made the decision, it is still possible to change your mind. Let the healthcare team know and they will make sure that your wishes are recorded and any Advance Care Plan is up-to-date.
What are the options?
The options are likely to be slightly different depending on where you live, but the main places you can choose to die are:
- at home
- in a hospice
- in hospital
- in a nursing (care) home.
There are no right or wrong decisions. It is about choosing where you feel most comfortable and what works best for you and the people who are important to you.
Will you be able to die where you choose?
Those caring for you will do their best to make sure you can die where you choose, but sometimes there are reasons why it isn’t possible.
Some things you can plan ahead for and try to find an option that works for you. Other things are less predictable - such as if the person caring for you becomes unwell or if you develop a new symptom that can’t be managed at home. In these cases, your healthcare team will always talk with you about how best they can still meet your wishes.
I have elected to be treated in a hospice when my number is called. In the meantime, I have been attending a day hospice and got to know all the staff and other patients. It's just one day a week and we meet for a few hours and then have lunch - not a bad way to spend the day.