If asked, many people say they want to die at home. This may be because they want to be around familiar surroundings and people. While this option is not for everyone, if you do want to be at home, support is available. This may vary from a few hours a week to 24-hour care. 

Even if you live alone, with planning, you can stay as long as possible in your own home. Sometimes people go into a hospice or hospital to have symptoms managed or to give their carers a break (respite), and then return home.

You can decide at any stage to change your mind about staying at home and explore other options. If you are planning to die at home, talk to your GP or palliative care team about ways of dealing with unexpected medical events. Keep a list of phone numbers handy to call if you need advice and support. 

Key points:

• Being cared for in a familiar environment surrounded by people you know well may help you maintain emotional wellbeing.
• Allows you to spend more time with family and friends by your side.
• May offer more opportunities to maximise quality of life.
• May feel more natural and less clinical, while still giving you access to expert medical advice and symptom control.
• Allows you a sense of control over the last part of your life.
• Your family and friends may find comfort in providing most of your care.
• A range of services can give you and your carers help and support.
• After death, family and friends can grieve at their own pace and decide when to call the ambulance or funeral home. 

Specialised palliative care facilities are called a palliative care units. They are sometimes called a hospice, and may be standalone facilities or a room within a hospital.

Palliative care units focus on caring for people with a life-limiting illness and aim to maintain quality of life. They are run by health professionals who specialise in providing physical and emotional comfort to the patient, and supporting the family before and after the death.

Palliative care units and hospices are different from most hospital wards. They are usually quieter and calmer, and have a more homely environment. Many people value the relaxed surroundings, as well as the skilled staff and expert symptom management.

These facilities often provide short-term respite care as well as longer-term care. Sometimes you can go back and forth between a palliative care unit and another setting during your final weeks. Many facilities now have a maximum length of stay, so you may want to check this with them ahead of time.

You may choose this option if you want to relieve your family from caring for you while you are dying, although they can still be involved. This can include feeding, bathing or simply being present.

Some people and their loved ones are unsure of when to contact a palliative care unit. They may wait to call until the final days, possibly missing out on the support that a palliative care unit or hospice has to offer. Some facilities have waiting lists, so talk to your palliative care team about when would be an appropriate time to make the first contact.

Key points:

• Offers a welcoming and comfortable physical environment.
• Provides 24-hour care with expert pain and symptom control.
• Focus is on quality, not length, of life.
• Allows the patient and their family and friends to focus on being together.
• Direct access to a team of professionals and volunteers trained to meet the needs of the dying person, and carers.
• Carers can leave at the end of the day and get some rest.
• Some families prefer not to live in a house where someone has died (although others find this a comfort).

Even when death is expected, more people approaching the end of life die in hospital than anywhere else. While some people feel more secure being near health professionals, others feel anxious about hospital care.

If you have spent a lot of time in hospital during your illness, you may want to stay on the same ward where you are familiar with staff and surroundings. You’ll need to check if this is possible. To help create a more homely environment, ask if you can bring in items from home, such as a favourite blanket or photos.

Decisions about your care may be made without your input. Hospitals sometimes provide medical interventions, such as resuscitation and intravenous lines, that may not be what you want in the final weeks or days of life. Your health care team should work with you to make sure your care plan matches your preferences.

If you are concerned, talk to the hospital staff and request that you don’t receive such interventions. You can arrange to have your wishes recorded in an advance care directive before an emergency occurs. It can also help give you control over the type of medical treatment you receive.

Key points:

• Experienced medical and nursing staff are available at short notice to manage physical symptoms (e.g. pain, fatigue, breathlessness, delirium) and emotional needs (e.g. anxiety, agitation).
• Able to make an organ donation.
• Carers can leave at the end of the day and go home to get some rest. But some carers may find leaving you to go home difficult.
• Provides 24-hour care.
• Some families prefer not to live in a house where someone has died (although others find this a comfort).

A residential aged care facility is a place where people stay who need continual care and help with daily living. These facilities cater for people with a range of chronic conditions, and nurses and aged care workers can provide care 24 hours a day. Some aged care facilities also provide respite and end-of-life care.

Some people fear that dying in residential aged care will be unpleasant and perhaps impersonal. But dying in an aged care facility can be comforting, particularly if it has been your home for a period of time and you are familiar with the staff, who will try to make you comfortable.

If you want to die in a residential aged care facility, ensure that you have an advance care directive in place. Talk to your care providers about avoiding an unnecessary transfer to hospital at the end of life. 

Key points:

• A less clinical environment than some hospitals.
• Experienced staff to manage symptoms and needs.
• May be located close to carers, family or friends.
• Provides 24-hour care.
• Family and friends can go home to get some rest. But some carers may find this difficult.
• Some families prefer not to live in a house where someone has died (although others find this a comfort).

A will is a legal document that sets out what you want to happen to your assets after you die. These assets are called your estate and may include your house, land, car, bank accounts, jewellery, clothes, household goods or investments. A will can also record your wishes regarding guardianship plans for children.

Making a will is not difficult but it needs to be prepared and written in the right way to be legally valid. A will should be reviewed and updated as circumstances change. It is best to ask a lawyer to help you or contact the Public Trustee in your state or territory. For more information, call Cancer Council’s Legal Referral Service on 13 11 20.

When you die without a will, you are said to die intestate. Your assets are distributed to family members according to a formula provided by the law. Although any will can be challenged in court, having a valid will usually means your assets will go to the people of your choice, avoids extra expenses, and simplifies the process for your family.

You can appoint someone to make medical decisions for you if in the future you lose capacity to make these decisions yourself. This person is called a substitute decision-maker. They should be someone you trust, who understands your values and preferences for future care and can make the decision you would have wanted. They do not necessarily have to be a family member.

Depending on where you live, the documents for appointing this person may be called a different name. If you do not have an advance care directive or an appointed substitute decision-maker, the law in each territory or state outlines who may make medical treatment decisions for you. 

You can record your wishes for your future medical care in an advance care directive – what this is called varies depending on your state or territory. This will only come into effect if you can’t make decisions for yourself. It provides a record for doctors, family and carers to consider, and may be legally binding in some states and territories. Depending on where you live, the advance care directive may be called an advance health directive, advance personal plan or similar.

Keep a copy of your advance care directive for yourself and share copies with your GP, oncologist, substitute decision-maker and loved ones. Ask your doctor or the hospital to place your directive on your medical record. You can also save a digital version online.

If you use social media, such as Facebook, Twitter, Instagram and LinkedIn, you may want to think about what happens to your accounts after your death. Each social media platform has different rules for deactivating accounts, while some allow your account to be turned into a memorial page.

It is a good idea to prepare a list of all your social media accounts, passwords and instructions and leave it with someone you trust, so they can manage your ongoing digital presence according to your wishes. Facebook lets you nominate a legacy contact, who can look after your account if it is memorialised. They may need to provide proof of death documentation to delete or deactivate your account. 

For more information, read Palliative Care Australia’s Guide to a Social Media Afterlife.

Voluntary assisted dying (VAD) is when a person with an incurable condition or illness chooses to end their life with the assistance of a doctor or health practitioner – using specially prescribed medicines from a doctor. 'Voluntary' means that it is the choice of the unwell person to end their life. VAD is not part of palliative care.

VAD is only available to people who meet all the strict conditions and follow certain steps as required by the laws in their state or territory. It is essential to check the latest updates and know the law and rules around this choice in the state or territory where you live.

As of July 2023, laws around VAD have been passed in all six states. However, they still may not have come into effect in your state or territory, meaning that it still may not be legal to participate in VAD. The laws in the Northern Territory and ACT were under review as of July 2023. For information and updates on VAD for your state or territory, visit Queensland University of Technology’s End of Life Law in Australia website.