Increasing numbers of people are expressing a wish to die in their home, which might be their own home or a care home, instead of in a hospital so that they can have their friends and family with them.

Residential and domiciliary care providers, therefore, are likely to be involved in the care of people who are terminally ill. When involved they must follow current national best practice end-of-life care standards with staff trained to achieve them.

The quality of the care that service users receive in their last days is just as important as the quality of life which they experience prior to this; perhaps even more so. The physical and emotional needs of service users must be met as they die, their comfort and wellbeing should be attended to and their wishes respected. Their pain and distress should be controlled and their privacy and dignity maintained.

A dying person must be given personal, physical and emotional care to high standards to enable them to die with dignity, in comfort and free from pain, surrounded by people who care for them. The NHS End-of-life Care Programme and its successors show how the quality of end-of-life care across the spectrum of health and social care services can be improved.

The coronavirus (Covid-19) pandemic presented specific challenges for care home service users, their families and the staff with regard to end-of-life care provision. Care home service users have proven to be particularly vulnerable to the infection and outbreaks in care homes proved devastating.

Restrictions on visiting and social isolation or shielding have resulted in issues for those at the end of life and for service users with dementia.

The Government acknowledged the lockdowns have been very difficult for many service users and families, and guidance on visiting is currently being implemented.

Although the rate of infection is decreasing, restrictions still need to be adhered to and it remains likely the frequency of visits and visitors will be limited and/or controlled for the foreseeable future.

All older care home service users have now been offered a Covid-19 vaccination and this is having a positive impact protecting this vulnerable group and a reduction of mortality caused by Covid-19 is being seen.

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