Planning end of life care means thinking ahead about the support, treatment and practicalities you would want if you became seriously ill or near the end of your life. It’s about staying in control: recording your preferences, easing pressure on the people close to you, and ensuring your medical, personal, emotional and spiritual needs are respected.
This complete UK guide gives you clear, step‑by‑step help: when to start and who to involve, choosing care settings, understanding your care team, what to include in an advance care plan, the legal tools (ADRT, DNACPR, ReSPECT and power of attorney), money matters, and funeral choices including direct cremation. We’ll share checklists, templates and trusted resources. Let’s begin with what end of life care means today.
What end of life care means in the UK today
End of life care in the UK is personalised support for people approaching the end of life. It focuses on comfort, pain and symptom control, plus emotional and practical help for you and your family. It can be provided at home, in hospital, a care home or a hospice, and is delivered by GPs, district nurses and palliative specialists working together. Planning end of life care means recording your preferences so your wishes guide every decision.
When to start planning and who to involve
Start planning end of life care as early as feels right — don’t wait for a crisis. Key moments include after a serious diagnosis, when your health changes, or during reviews. If your condition may deteriorate you should be offered advance care planning before any loss of capacity. Involve people important to you, your GP and community/district nurses, and specialist or palliative care teams (including hospice staff). Social workers can help with practicalities, and a health and welfare attorney can speak for you if needed.
Personalised care and your values: what matters most
The heart of planning end of life care is making sure care reflects you — your values, goals and daily preferences. Capture these in an advance care plan or advance statement so everyone understands what matters most and can act on it if you cannot. Think beyond treatment to the people, places and practices that bring comfort.
- What matters most: your priorities, fears and hopes
- Place of care and death: where you’d prefer to be
- Who to involve: key people and faith leads
- Routines and beliefs: cultural/spiritual needs, comforts
- Care preferences: what you do and don’t want
Care settings: home, hospice, care home or hospital
Choosing where care happens should match your needs, preferences and clinical situation. Planning end of life care lets you record a preferred place of care and death, while keeping options open if things change. Many people move between settings, with community, hospice and hospital teams coordinating support so comfort, dignity and control are maintained.
- Home: familiar; needs district/palliative nurse input, equipment and carer support; plan early for 24/7 advice and medicines access.
- Hospice: specialist palliative care with holistic support for you and family; free of charge; referral via GP/hospital; often flexible visiting.
- Care home: 24/7 personal care with GP/community input; helpful when care needs exceed what’s possible at home.
- Hospital: for acute treatment or complex symptom crises; clear plans can help avoid unwanted admissions if you prefer to be elsewhere.
Your care team: roles, access and coordination
When you’re planning end of life care, a co‑ordinated team works around you. Your GP and community/district nurses lead day to day, bringing in hospice and specialist palliative support when needed. Social care and therapies help at home. Many areas offer out‑of‑hours advice. Make sure your plan is in your notes and shared.
- GP: overall medical lead, referrals and medication reviews.
- District nurses: home visits, symptom control and practical care.
- Specialist palliative/hospice team: complex pain relief, holistic support.
- Social worker: care coordination, practical and benefits guidance.
- Therapies/pharmacy: equipment, mobility, safe and timely medicines.
Advance care planning: what to include
An advance care plan (often called an advance statement) records what matters to you and how you want to be cared for if you can’t make or express decisions later. It’s voluntary, best started early when planning end of life care, and should be attached to your medical notes and shared with your GP, district nurses, hospice team and the people close to you. Review it regularly.
- What matters most: your priorities, values, worries and goals.
- Place of care and death: where you’d prefer to be looked after and die.
- People to involve: who you want with you and who should be contacted.
- Treatment preferences: types of care you would or would not want.
- Comfort and beliefs: routines, cultural/spiritual needs, and what helps you feel safe.
- Who speaks for you: named health and welfare attorney or key contacts.
Your plan can sit alongside formal tools (ADRT, DNACPR, ReSPECT and power of attorney) — covered next.
Legal tools and decisions: ADRT, DNACPR, ReSPECT and power of attorney
Alongside your advance care plan, formal tools help ensure your choices are understood and followed if you cannot decide at the time. Complete them early, review regularly, and involve your clinicians. Crucially, DNACPR decisions must never be applied in a blanket way; they must be individualised and discussed with you and, where appropriate, your family or carers.
- Advance Decision to Refuse Treatment (ADRT): a legally binding decision to refuse specified treatments in future. It must be in writing, made by an adult (18+) with mental capacity.
- DNACPR: records a decision specifically about cardiopulmonary resuscitation. It should be personalised, not applied to groups, and discussed and recorded by your team.
- ReSPECT: a Recommended Summary Plan for Emergency Care and Treatment used in many areas to capture what matters to you and clinical recommendations in a crisis.
- Power of attorney: appoints a trusted person to make health and welfare decisions if you lose capacity (name and process differ across UK nations).
Next, how to create, record and share your plan.
Step-by-step: how to create, record and share your plan
Break the process into small steps. Capture what matters, turn it into clear instructions, and make it easy to find. Advance care planning is voluntary and should match local practice—ask your GP or nurse which documents are used locally (for example ReSPECT) and how services access them.
- Start the conversation: speak to your GP or district/palliative nurse.
- Map what matters: values, preferred place, people to involve, treatments.
- Choose tools: advance statement, ADRT, DNACPR, health and welfare attorney.
- Write it clearly: use local forms; be specific; sign and date.
- Clinician review: agree recommendations; add to your medical notes.
- Share and store: copies to GP, nurses, hospice and key people.
Reviewing and updating your plan
When planning end of life care, treat your advance care plan as a living document. Review it regularly and whenever your situation or wishes change – after a new diagnosis, hospital admission/discharge, or a move between care settings. If you have an ADRT, DNACPR, ReSPECT form or health and welfare attorney, review these too. Record, sign and date updates, then share them with your GP, district nurses, hospice team and key people.
Comfort and symptom management: palliative care basics
Palliative care underpins planning end of life care. It focuses on comfort, dignity and quality of life through pain and symptom control, while supporting the emotional, social and spiritual needs of you and your family. Your GP, district nurses and specialist palliative teams work together across home, hospice, care home or hospital to keep you comfortable and in control.
- Skilled nursing and medical care: pain and symptom control.
- Emotional support: counselling and space to talk.
- Spiritual/religious support: respect for beliefs and rituals.
- Complementary therapies and creativity: relaxation and wellbeing.
- Practical advice and physiotherapy: comfort, mobility and independence.
- Bereavement support: help for those close to you.
Practical arrangements at home: equipment, medicines and out-of-hours help
When planning end of life care at home, it works best when practicalities are set up early. Ask your GP or district nurse for assessments so equipment, medicines and contacts are ready before a crisis. Work with the palliative team and an Occupational Therapist, and keep your GP updated.
- Equipment: hospital bed, walking frames and other aids via OT/palliative team.
- Medicines: agree medicines with your team; palliative nurse provides prescriptions; brief your pharmacist.
- Out‑of‑hours help: display 24/7 numbers for the palliative/hospice team; ask about overnight respite.
Talking with family and clinicians about your wishes
As part of planning end of life care, talking with family and clinicians about your wishes can feel daunting. Start early, when things are relatively calm, and frame the chat around what matters most to you. Invite the people you trust, and ask your GP or district nurse to join or explain options in plain terms. Take it in short conversations, allow silence, and remember you can change your mind. Decisions like DNACPR should never be applied in a blanket way; they must be discussed and personalised.
Money and legal matters: benefits, wills and digital legacy
Sorting money and legal basics early eases pressure on everyone. When planning end of life care, check your benefits, make a valid will, and decide how your online life should be handled. Keep things simple, tell the right people, and review as circumstances change.
- Benefits check: Ask your GP, social worker or a carers’ charity to review entitlements. If you enter a hospice, DLA, PIP or Attendance Allowance can continue if DWP is told in writing; Carer’s Allowance may continue if still eligible.
- Will and executors: Make or update a will, name executors, note gifts, and tell trusted people where it is.
- Digital legacy: List key accounts and devices, state memorialise or delete, and who manages them.
Funeral choices in your plan: direct cremation and alternatives
When planning end of life care, include clear funeral preferences to remove pressure and costs. Note whether you’d like cremation or burial and the type of send‑off. Many people now choose direct cremation – a simple, unattended cremation that’s dignified, cost‑effective and eco‑friendly, with ashes returned or scattered and a later celebration of life.
- Direct cremation: unattended; professional care; ashes delivered or scattered.
- Cremation with service: ceremony at the crematorium.
- Burial or green burial: graveside service; consider plot.
Support for carers and where to get help
Caring at the end of life can be exhausting and isolating. Planning end of life care should include support for you as a carer—emotional, practical and financial. Ask early; teams can put help in place before a crisis and stay involved as needs change.
- GP and district nurses: coordinate care, review medicines and refer to specialists.
- Specialist palliative/hospice teams: expert symptom control, counselling, spiritual care and bereavement support; free; referral via GP/hospital.
- Out‑of‑hours help: many palliative/hospice teams offer 24/7 phone advice.
- Social worker/OT: equipment, home support and benefits guidance.
- Pharmacist: urgent supplies and medication advice.
- Carers’ charities: practical guides, benefits checks and emotional support (e.g., Marie Curie Support Line 0800 090 2309).
- Respite: ask palliative/district nurses about overnight cover if you’re not sleeping.
UK nation differences and key resources
Principles are UK‑wide, but terminology, forms and legal processes differ. Scotland uses anticipatory (future) care planning; Wales also says future care planning. Power of attorney and emergency plans vary, and ReSPECT is used in many areas only. Follow nation‑specific guidance.
- England & Wales: NHS end of life care, Compassion in Dying planning, ReSPECT common.
- Scotland: Anticipatory Care Plan (ACP) resources; Marie Curie guidance for Scotland.
- Northern Ireland: NI Direct information; Compassion in Dying NI; court‑appointed ‘controller’ if no attorney.
End of life planning checklist and templates
A simple checklist makes planning end of life care clearer and helps clinicians act on your wishes. Use your local advance care plan (or anticipatory/future care plan) and, where used, the ReSPECT form. Free planning packs are also available from national charities. Attach your plan to your medical notes and share copies with your GP, district nurses and key people.
- Your priorities and values: what matters most.
- Preferred place of care/death: home, hospice, care home or hospital.
- People to involve: names and contacts.
- Treatments to refuse (ADRT): if wanted; signed and specific.
- Resuscitation decision (DNACPR): discussed and recorded, never blanket.
- Emergency plan (ReSPECT): if used locally.
- Health & welfare attorney: named attorney and details.
- Comfort, routines and beliefs: what helps you feel safe.
- Storage and sharing: who has copies; review date set.
Your next steps
You now have what you need to stay in control. The next hour can secure real peace of mind: book time with your GP or district nurse, decide who you want involved, and note your funeral preference. Then turn your wishes into clear paperwork, share it, and set a date to review.
- Capture what matters: write a short values statement.
- Book an ACP conversation: ask your GP/district nurse which local forms are used (e.g. ReSPECT).
- Name who speaks for you: start health and welfare power of attorney paperwork.
- Record decisions: complete an ADRT if refusing treatments; discuss DNACPR.
- Share copies: GP, district nurses, hospice team and key people; keep one at home.
- Set a review date: add it to your calendar.
- Choose your funeral option: if you prefer a simple, dignified send‑off, talk to Go Direct Cremations for straightforward guidance and support.