An end of life care plan is not about giving up. It records what matters to a person and how they would like to be cared for as they approach the end of their life. It can help families and healthcare professionals make decisions about treatment, symptoms, comfort and personal wishes.

You may also hear this described as advance care planning, a personalised care plan or planning ahead for end of life care.

What does an end of life care plan include?

Every plan should be shaped around the person. It may record:

• how symptoms such as pain, breathlessness, sickness or agitation should be managed

• where the person would prefer to be cared for, if this is possible

• who they would like involved in discussions and decisions

• treatments they would or would not want to consider

• religious, spiritual, cultural or personal wishes

• what brings them comfort and who to contact if things change 

An end of life care plan may also explain how medicines could be given if the person can no longer swallow, for example by injection, patch or syringe driver.

For more information on syringe drivers, read our What is a syringe driver? article.

Does an end of life care plan mean care is stopping?

No. It usually means care is being focused more clearly on what the person needs now. This can include treating symptoms, supporting comfort, avoiding treatment they don’t want and helping everyone feel less uncertain.

Sometimes the focus changes from trying to cure an illness to helping someone live as comfortably as possible. That can be hard to hear, but it does not mean that care or support is being withdrawn.

Does it mean someone will die soon?

Not always. Some people have a plan for their last days or weeks of their life, others plan months or longer in advance while living with a serious illness.

A care plan cannot predict exactly when someone will die. It helps the care team understand what matters to the person whenever their condition changes.

Who makes an end of life care plan?

Where possible, the person needing the end of life care plan should be at the center of the conversation. Family members, friends or carers can also be involved if the person wants them to be.

Doctors, nurses and other professionals should explain the choices, answer questions and record the agreed plan. The plan should be reviewed and can be changed if the person’s wishes, needs or condition change.

Is an end of life care plan legally binding?

A general care plan records wishes and preferences, but it is not usually legally binding on its own. Other documents have different purposes. These can include an Advance Decision to Refuse Treatment, a Lasting Power of Attorney for health and welfare, or a DNACPR decision about cardiopulmonary resuscitation.

A healthcare professional can explain which documents are relevant and how they work alongside the care plan.

What questions can I ask?

It’s okay to ask for clearer explanations or to hear information more than once. You might ask:

• Why is an end of life care plan being discussed now?

• What does this mean for their care and treatment?

• Can the plan be changed, and who will be able to see it?

• Who should we contact if we are worried?

Recording other personal wishes

An end of life care plan focuses on care, treatment and comfort. There may be other things the person wants those close to them to know, such as wishes about music, readings, pets, belongings, important contacts or funeral preferences.

Our My Wishes document can help someone record these details in one place. It is not a medical care plan, but it can sit alongside conversations about what matters most.

Learn more about our My Wishes Checklist.