Everyone, whatever their age, should be able to expect a death that involves privacy, dignity and good quality care in comfortable surroundings, with adequate pain relief and appropriate support (General Medical Council, 2006). For some people, it may be more useful to think of a ‘final phase of life’, in which gradually increasing physical deterioration leads to changes in psychological and existential orientation. This has implications for care planning and the timing of discussions, particularly for frail older people with life-limiting illness. It is important to do the following: