End of life care

9. Place of death

A person with dementia should be supported to die in a place of their choice whenever possible. For many people this will be somewhere familiar such as their own home or the sheltered housing or care home in which they live.

However, many people with dementia are admitted to hospital towards the end of their lives and end up dying there. Moving to a busy and unfamiliar environment such as a hospital ward is often difficult or distressing and not what most people would have wanted.

If the person has previously expressed a preference to be cared for where they usually live, this should be included in their care plan. This will help avoid an unnecessary admission to hospital at the end of life. Achieving this will require that all those involved in the person’s care know about this preference.

If the person is living in their own home and has expressed a wish to die there, talk to professionals caring for the person early on about this. This allows time for plans to be made so that the person is able to die at home.

The person’s environment

When a person with dementia is near the end of life it is important that they are in an environment where they feel comfortable and their needs are supported. It can help to make the environment familiar – for example, by including familiar objects and pictures. The space should be peaceful and not too overstimulating (without too much background noise or visual clutter).

The environment should support the person to engage in different ways – engaging with other people, any spiritual needs, and with their senses. This may take many forms and should be based on the person and their unique interests. However, it may include:

  • being near a window
  • access to nature
  • familiar smells
  • music
  • enough space for those important to the person to be with them.

It is important that the environment supports the person’s privacy and dignity. A good environment should also support staff and those close to the person. It should provide space for them to process what is happening and can help them know the person is comfortable and in a place that is supporting their needs.

Technology may be helpful for supporting the person at the end of life but should be based on the individual and what works for them. Some electronic aids include:

  • pressure sensors – these are sensors that can be placed under a bed or chair and can raise an alert when the person moves or gets up
  • fall sensor – a device that registers if the person wearing it falls over
  • sensory lights – lights designed to give a stimulating, engaging or calming effect, which can help the person to engage with the world around them
  • tablets or computers – images or videos on these can also help the person to engage with the world around them.