End-of-life care
End-of-life care at home with the family close
Most people say they would rather be at home, and with the right support that is possible more often than families expect. A carer who has done this before, working alongside the district nurses and the GP, is usually what makes it manageable.
3,500+ vetted carers, with their experience described on their profile
If it is urgent, call 0203 369 3624 and we will look for you today.
Who is involved
Who is involved, and what each of them does
Care at home at this stage is shared between the family, the carer and the NHS. The district nurses and the GP provide the nursing, at no cost, and a carer covers the hours in between. That leaves the family free to be the family.
You and the family
Always
You are there for the company and the decisions, and you know the things nobody else knows. Nobody expects you to do the nursing as well.
The carer
Daily visits, nights, or live-in
Washing, turning, mouth care, meals while they are wanted, medication on time, and a hand to hold at three in the morning. They are the person who is there.
District nurses
NHS, free
Syringe drivers, pressure care, catheters and the medicines box. They visit, but they do not stay.
Visits, often daily near the end
The GP
NHS, free
Prescribes anticipatory medicines, signs the forms that matter, and is the person the nurses phone.
On call, and visits when needed
Hospice at home
NHS, free
Specialist palliative nurses for pain and symptoms that are hard to control. They also advise everyone else involved, and they sometimes give hands-on care.
Referred by the GP or hospital
Out of hours
NHS, free
The number on the fridge for the night the syringe driver alarms or the pain breaks through. Every area has one.
Nights and weekends
Apart from the family, the carer is the only one of these who stays. Everyone else comes and goes, and that is usually why families remember the carer.
What it can look like
What care at home looks like, and where the carer fits
No two are the same. This is the shape most families recognise afterwards.
- 1
Getting home
What happens
This usually begins with a hospital discharge with a care package, or with a decision at home that treatment has run its course. The GP starts the paperwork: a DNACPR if that is wanted, anticipatory medicines, and a referral to the district nurses.
The carer
Visits begin, often mornings and evenings, and sometimes a sleeping night so that the family can rest.
- 2
The middle weeks
What happens
Appetite goes and sleep increases, and the day gradually shrinks to one room. The nurses manage the pain and the breathlessness, and comfort is managed by whoever is there.
The carer
The carer does the personal care, keeps the mouth moist, turns them every few hours, and notices what has changed before anyone else.
- 3
The final stretch
What happens
There are long periods of sleep, changes in breathing, and no interest in food or drink. The nurses may set up a syringe driver, and the family usually gather.
The carer
A carer awake through the night lets the family sleep and be present in the day. Live-in or waking nights are usual here.
- 4
After
What happens
When the time comes, the GP or nurse attends. Nothing has to happen quickly. What the carer does next is for the family and the carer to agree, whether that is help with the practical things for a short time or stepping back straight away.
The carer
Staying in touch with the carer afterwards is up to you both. They were there for all of it.
When to ask for help
- A hospital has said there is nothing more to be done
- They have said they want to be at home
- Pain, sickness or breathlessness is not controlled
- The family carer has not slept properly in a week
- Personal care is now more than one person can manage
- You are frightened of the nights
Any one of these is reason enough. Call 0203 369 3624 or read about private palliative carers.
Cost, and who pays
The NHS may pay, through fast-track funding
NHS Continuing Healthcare has a fast-track route for people whose health is getting worse quickly and who may be nearing the end of life. A GP, consultant or district nurse completes one form and the NHS decides whether to fund the care it assesses as needed. It is worth asking for it by name. The nursing, the GP and hospice care are free either way. If fast track is refused, delayed or does not cover everything you want, these are the figures for care with our fee included.
How it works
From “something has to change” to a carer at the door
No assessment visits, no waiting list. Some families are talking to a carer the same day.
Search your postcode
See the carers who cover it, with photos, rates, experience and reviews. Filter by hourly, live-in or overnight.
Talk to the ones you like
Message them directly, or tell us what you need and we can suggest some carers to look at. The choice is always yours.
Meet before deciding
A call, a video chat or a visit, free and before anything is booked. A lot of families have a good idea within the first ten minutes.
Book, and change it as needs change
Contract, insurance and payment run through us. You can add visits, add nights, or move to live-in care as things change, and you only pay for care that happens.
Safety first
Someone coming into their home? We take that seriously.
Letting a carer into the home of someone you love takes trust. We've built every layer of protection so that trust is earned, not assumed.
Vetting before a carer appears
Enhanced DBS, ID and right-to-work checks and an online interview before a carer appears, with renewal or rechecks depending on the accepted route. We check that a carer is caring; their skills and training are for you to check with them.
Insured and above board
Every visit is insured, contracted and paid securely online after care happens. There is no cash and no informal arrangement to manage.
A real person who knows you
Your own account manager and a UK support team who know you, your carer and your situation, not a call centre script.
Help when plans change
If your carer is unwell or away, our team will always do their best to find you vetted cover at short notice.
What clients say
Our Latest Carer Reviews
Margaret N
"Excellent - Lovely lady. My mother is so pleased with the work she does in helping her."
Read the full review
Julia S
"Julia is a highly skilled and companionate carer who is able to give so much of herself and adapt to any situation."
Read the full review
Andres Felipe C
"My son who he is caring for automatically welcomed Andres and can be heard laughing & having fun with Andres."
Read the full reviewQuestions families ask
End-of-life care, answered
Care in the last weeks or months of life, with comfort rather than cure as the aim: managing pain and symptoms, personal care, and support for the family. Palliative care is the wider term for symptom relief at any stage of a serious illness; end-of-life care is the last part of it. Who is involved.
Yes, and it is most people’s stated wish. It needs three things: the nursing (district nurses and the GP, free), the hours of hands-on care (a carer, or family), and anticipatory medicines in the house. With those in place, most deaths that would otherwise happen in hospital can happen at home. What the weeks look like.
Washing, turning, mouth care, changing, meals while they are wanted, medication on time, and being there. They notice the changes that matter and tell the nurses. Through the last days a carer awake at night lets the family sleep. Private palliative carers.
The nursing, the GP and hospice care are free. For care at home, the NHS may pay through fast-track continuing healthcare: a GP or nurse completes a form and the NHS decides whether to fund the care it assesses as needed. Where it is not in place, or does not cover everything, daily visits are £18 to £25 an hour and live-in care from £1,260 a week. Funding explained.
Often within days. Call 0203 369 3624 and we will look for carers near you who are free now, and you can read about each carer's experience on their profile before you meet them. There is no waiting list.
Carers prompt and give prescribed medicines by mouth or patch. Syringe drivers and injections are set up and managed by the district nurses, who visit as often as needed. The carer watches for breakthrough pain and calls them.
No. Respite is a break for the family carer at any stage. It is often used during end-of-life care, so the family can rest, but the two are not the same thing. Respite and end-of-life care, explained.
Late-stage dementia is an end-of-life condition, and care at home follows the same shape: personal care, comfort, familiar faces and a calm room. A carer who has known the person for months matters more here than anywhere. Dementia care.
The NHS provides the nursing at home free of charge, through the district nurses and the specialist palliative care team. PrimeCarers does not introduce nurses and does not check nursing registration, so if you need paid nursing on top of the NHS visits, a nursing agency is the route. Can you get live-in nurses?
Look for palliative experience on the profile, and ask about it directly at the free interview. Then choose the person your relative is most at ease with. Steadiness matters more than qualifications here. How we vet carers.
Guides
Read next
The pages families read in these weeks.
- End-of-life care at home: the guide
- The last months and weeks
- The last days and hours
- Pain and symptoms at home
- Eating and drinking near the end
- The cost of end-of-life care at home
- Hospice care explained
- Choosing where to die
- Talking about dying with a parent
- End-stage dementia care at home
- Heart failure, COPD and kidney failure at the end
- Looking after yourself at the end
- Private palliative carers
- The first days after a death at home
- Is respite care the same as end-of-life care?
- Palliative care for dementia
- Overnight care
- Live-in care
- Can you get live-in nurses?
- Leaving hospital: what to arrange
- Help paying for care
- Am I legally responsible for my elderly parent?
- Will writing and protecting assets
- Respite for the family carer
- The cost of care
- Palliative, end of life, hospice at home
- Fast-track continuing healthcare
- Who is in the team
- What a carer does at this stage
- Live-in care at the end of life
You do not have to do this alone
When you are ready, talk to us. We will look for carers near you who have done this before, and you choose who it is.