What is a 'good death'?

At Marie Curie, we define a good death (or good end of life experience) as having the right care, support and systems in place, so you feel protected and safe, and your carers and loved ones understand what support is available.

A good death will be different for everyone, as it depends on what matters to you.

What are the principles of a good death?

There are, however, a few principles that help ensure that you get a good death, whatever the illness, whoever you are.

• Pain and symptom management: If you're living with an illness you're likely to die from, it's important to manage any pain and symptoms, and get the right medical care to help you live as well as you can, in line with your wishes. This means being able to access and plan the care you need – and get urgent, unplanned care if you need it.
• Emotional and spiritual support: If you're living with an illness you're likely to die from, or are close to someone who is, you might be feeling a range of emotions, from shock and anger to anxiety and loneliness. To feel safe and supported, emotional and spiritual care can be just as important as physical care.
• Focusing on what matters most to you: This could mean spending as much quality time as possible with your loved ones. It might be the physio support to do an activity you love, when you didn't think you could. Or being in the place you call home as you take your last breaths, with your favourite people and pets you by your side.
• Co-ordinated and easy-to-use services: A smooth and joined-up experience of the health and social care systems you're using can mean you're better able to focus on the important things at the hardest of times.

What's an example of a good death?

Hayley, whose husband Matt died from a brain tumour, believes that the pain management and focus on what was important to Matt meant that he had a 'good death' in the Marie Curie Hospice, Edinburgh.

"Seeing Matt in pain and having a nurse come and give him medication straight away was invaluable. The first night I left Matt, he had his sandwiches and French onion soup – I'd told Lewis and Richard, the Marie Curie Healthcare Assistants, it was his favourite.

They would just come and sit with me. To just have somebody come through and chat to you was amazing. They really helped Matt keep his dignity. A hospice is like a good death, and I think that's definitely what Matt got."

For Marie Curie Nurse Daniela Barbu, "A good end of life means ensuring the person has comfort and dignity, and the people come to them are supported by all our resources. End of life care has to be person-centred. When we manage to make the person comfortable, free of pain and their treatment is smooth, that's the best end of life." A good death, to her, isn't just about the person who's dying, it's also about the people close to them. "We're here to help people go peacefully and comfort the people close to them too."

When you get to live well right up until you die, and what matters most to you has been listened to and respected, that's what a 'good' death looks like.

What are the challenges to having a good death?

At Marie Curie, we know that many people don't have access the elements that contribute to a 'good death'. Every five minutes, someone, somewhere in the UK dies without the care and support they need. That's 150,000 people every year.

Some of the challenges include:

• Financial insecurity: Between April and September 2022, nearly one in five calls to Marie Curie's Support Line were from people affected by terminal illness who were concerned about their finances – up by 38% on the same period last year. For some, particularly those living in poverty, this could mean choosing between powering vital medical equipment, heating their home, or buying food. Worrying about money, when you should be making the most of your final moments, doesn't contribute to a good death.
• Gaps in care: In some areas, the specialist care and support people need at the end of life isn't available, meaning they find themselves in overstretched hospital A&E departments. Focusing on people's wishes means helping them die where they want to. For many, that's at home.
• Awareness: Some people may not know what support is available, from free emotional support to medical care at home or in hospices. Some people think palliative care is available only to people with terminal cancer, when in reality it can help anyone with an illness they're likely to die from. This includes Alzheimer's (and other forms of dementia), heart, liver, kidney and lung disease, motor neurone disease, and Parkinson's.

We believe this needs to change, so everyone gets the best possible care in their final years, months and days of life, reflecting what's most important to them.

We're working to make sure everyone can have a good death

Marie Curie is the UK's leading end of life charity, providing expert hospice care, whatever the illness, in the comfort of home and hospice. Good experiences at the end of life are possible, and we can help make this happen.

Alongside providing hands-on care and support, we're campaigning for a world where everyone gets the best experience possible at the end of life. We raise public awareness and influence decision-makers across the UK on the issues affecting people with an illness they're likely to die from, and those close to them.