Build a supported Plan A and Plan B
A preferred place matters, but it depends on symptoms, local services, carer capacity and wishes that may change.
A realistic place-of-care comparison
Review it when needs or available support change.
- Compare home, hospice, hospital and care-home options available locally.
- Name what matters most about the setting.
- Ask what daytime, night, weekend and emergency support actually exists.
- List equipment, medicines, access and travel needed for each option.
- Discuss honestly what unpaid carers can and want to provide.
- Record a preference, backup, move triggers and review date.
Questions for the clinical and care team
Ask for the service hours, not only the service name.
- What support is available in each setting?
- What would make this place feel safe and comfortable?
- What happens if symptoms or carer capacity change?
- Who should hold and review the plan?
Hold preference and reality together
A carer’s limit belongs in the plan.
“My preference is this place, but I want a realistic backup.”
“I cannot promise this level of home care without professional support.”
Turning a preferred place into a flexible care plan
Home, hospice, hospital and care homes offer different kinds of support. A preference matters, but it is not a promise that carers must fulfil at any cost.
Begin with what the place represents: familiar surroundings, privacy, symptom expertise, proximity to family or relief from caring responsibilities. Ask what services are actually available locally, including overnight, and how quickly additional support can be arranged.
A home plan must include the honest capacity of family or friends. Love does not create nursing skills, physical strength or endless wakefulness. Record the preferred place and a backup, share them with the relevant team and review both when symptoms, services or wishes change.
A practical way through it
Use the parts that fit your situation and leave the rest.
- Identify the underlying prioritiesList what matters about place, including people, pets, privacy, medical support, visiting, faith needs or avoiding travel, before choosing a setting.
- Ask what exists locallyDiscuss home nursing, hospice inpatient and community services, hospital care, care homes, equipment and overnight contacts with the GP or palliative-care team.
- Assess carer capacity honestlyAsk each expected carer what they can and want to do, including lifting, medicines and nights. Record where professional help or training is required.
- Plan symptom and medicine supportAsk who supplies equipment and medicines, who may administer them, whom to call when symptoms change and what could require transfer.
- Record and share preferencesUse the locally recognised advance- or anticipatory-care process. Tell key professionals and trusted people where the current plan is held.
- Create a named backupChoose an alternative place and identify the trigger for reconsidering, such as symptoms that cannot be controlled or care that cannot be provided safely.
- Review without blameRevisit the plan after hospital admission, health change or carer exhaustion. A change of setting can be good care and does not erase the original preference.
What this can look like
Home care becomes unsafe overnight
Mavis wants to die at home, but her partner has had no sleep for three nights and cannot safely help her from bed. Both fear that asking for help will break a promise.
Using the backup as part of the plan
They call the palliative-care team, describe Mavis’s symptoms and the partner’s limits, and ask what urgent support is available.
If care cannot be made safe at home, they use the agreed hospice option and preserve the priorities that mattered most: comfort, privacy and family presence.
Explore what each place means
- Consider comfort, privacy, available support and what matters to you in each setting.
- Ask which services operate locally, including at night.
Include carers honestly
- Discuss what family or friends can safely provide and what professional help is needed.
- A plan for care at home should include an honest, blame-free assessment of what carers can and want to provide, what professional support is available and what the backup plan will be.
Record and review
- Share preferences with the GP, palliative team and important people.
- Keep a backup plan because symptoms, services and wishes can change.
A manageable next step
What you could do now
- Ask the local team what care is available in each setting.
- Talk honestly with anybody expected to provide care.
- Record a preference and a backup without treating either as fixed.
Checked sources
Read the original guidance
We summarise carefully and link to the source so you can check the full, most current information. Sources were checked 9 September 2026.