Where you can be cared for
Let's talk: advance care planning
At the end of your life, depending on your circumstances, you can be cared for in:
- a hospital
- at home
- a hospice
- a care home
If you are very ill and your health gets worse, there are a number of things to think about. For example, you might want to consider where you would prefer to be cared for.
Many of our patients would prefer to avoid coming into hospital and instead receive their care where they usually live. Many illnesses can be managed outside of the hospital or by coming to the hospital just for the day. You can access professionals, treatment and equipment where you are, through your GP. If you've planned to have your care at home, you can still come into hospital if you change your mind.
Most patients who come to hospital for their treatment are seen first in the emergency department, or A&E, before moving on to a general ward. Lots of treatments and procedures take place there, so it can feel quite busy.
Critical care, also known as high dependency or sometimes intensive care, is an area which can be very busy and involves very close monitoring. People who are admitted to intensive care may be connected to machines which provide organ support, sometimes known as life support. Some people may be sedated for a period of time during this treatment.
The experience of being in intensive care is highly demanding on the body and the mind. That's why it's really important to consider if this is the right thing to do for the patient.
Hospices provide care for people who have illnesses that won't get better. That includes conditions like dementia, heart and breathing problems and cancer.
Some people assume that hospices only provide care to people who are very close to death, but in fact lots of people choose to visit hospices for a short time to work on a symptom or a problem before going back home again. For example, someone with heart failure might choose to visit the hospice for a short time to work on their breathing problems and then they go back home.
Lots of hospices also offer other services that you can visit just for the day.
Please talk to your healthcare team if you would like more information.
In hospital
During your stay in hospital, we talk about your condition and treatment options with you.
Our nurses may measure your temperature, blood pressure, pulse and breathing rate every few hours, depending on your needs. These are called your vital signs. Monitoring you like this helps our staff decide when and where to get extra medical help if they are concerned about you.
A specially trained team responds if your condition gets worse. This clinical response team gives extra support on the ward. If you need more monitoring or treatment, we might move you to the critical care unit.
Critical care if your condition gets worse
In critical care, we can give you extra treatments and monitor you closely. Often we give organ support, which is sometimes called life support. This may include drips, tubes and machines to support your breathing or kidneys.
Sometimes, you might need to have sedation. This is when we give you a medicine to make you calm and sleepy until your condition is more stable.
The close monitoring in critical care supports people when they are seriously ill. We can also try to treat the cause of the illness.
Most people who need critical care recover and go back to the ward to get better. If someone has been seriously ill, it might take them a long time to recover. There might be long-lasting effects on the body or mind.
Not all people in critical care recover. This might be because they are very sick or have serious health conditions.
As with all treatments in hospital, we try to find the best option for you. It's important that any critical care has a realistic chance of helping you to get better.
At home
You might be able to have care where you usually live. Many illnesses can be managed outside of the hospital or by coming to the hospital just for the day. You can get access to professionals, treatment and equipment at home through your GP.
If you plan to have your care at home but change your plans later, you can still come into hospital.
In a hospice
Hospices give free care for people who have illnesses or conditions that will not get better, such as:
- cancer
- dementia
- serious heart and breathing problems
Some people assume that hospices only care for people who are close to death. However, lots of people visit hospices for a short time to improve a symptom or problem before going back home again. For example, someone with heart failure might visit a hospice for a short time to work on their breathing problems and then go back home.
In a care home
You can choose to have end of life care in a care home. Here, trained staff look after you day and night. Professional carers can help with things like:
- washing
- getting dressed
- giving you meals
- taking medicines
There might also be registered nurses who work in the care home. Other healthcare professionals who might visit people in care homes include:
- GPs
- palliative care staff
- community teams
A care home with nursing is sometimes called a nursing home. There are qualified nurses on duty if you regularly need skilled nursing care. For example, a nursing home is suitable for people with a disability, serious long-term condition or very restricted movement.
Care homes can be privately owned or run by voluntary organisations or the local council. Private care homes charge fees for your care. You can sometimes get help from the local council with paying these fees if you have few or no savings. Most people are expected to contribute towards the cost.
If you have a complex healthcare need, you may be able to get care for free under a programme called NHS continuing healthcare. This can include the NHS paying for your care home fees. You should be assessed under the programme if you decide to have end of life care in a care home.
The NHS website has more information about care homes and paying for your care.
Resource number: 5332/VER1
Last reviewed: November 2022
Next review: November 2025
