There is a particular kind of exhaustion that comes when you realise the person you love is not going to get better. Not gradually, not with the right medication or the right hospital team. Just not. Many families reach this point and find themselves in a strange administrative silence. The NHS has been brilliant in parts. The consultant has been kind. But nobody has sat down and explained what support is actually available to help your loved one stay at home, in the place they know, with the people they trust. You are left to piece it together yourself, usually at the worst possible moment.

If that is where you are right now, or where you can see yourself heading in the next few weeks, this article is for you. It is not going to pretend this is easy. It is going to tell you what you can ask for, and who to call.

What you are entitled to ask for

The first thing to know is that NHS-funded end-of-life care does not stop at the hospital door. Under NICE guidelines on end-of-life care, people who wish to die at home have a right to be supported in that choice, and the NHS has a responsibility to put a plan in place. That plan should involve your loved one's GP, a district nurse, and in many cases a community palliative care nurse from a local hospice or NHS team.

Ask the GP directly: has a palliative care referral been made? If not, ask for one now. You do not need to wait for a crisis. In London, most boroughs have a community palliative care team accessible via GP referral, and many work in close partnership with local hospices who can provide advice and short-term support even if your loved one never sets foot inside the hospice building itself.

Marie Curie also provides free nursing care at home for people who are dying, including overnight sits, through their community nursing service. This is free of charge. It is funded by donations and the NHS. Many families simply do not know it exists until someone mentions it in passing. You can call the Marie Curie Support Line on 0800 090 2309 to find out what is available in your part of London.

The funding question that most families miss

If your loved one's needs are primarily health-related rather than social care-related, they may be eligible for NHS Continuing Healthcare, often called NHS CHC or fast-track CHC in end-of-life situations. This matters enormously because it means the NHS, not the family, pays for care.

A fast-track assessment can be triggered by a clinician who believes a person has a rapidly deteriorating condition that may be entering a terminal phase. This can happen quickly, sometimes within days. It is worth asking the GP or hospital discharge team whether a fast-track CHC referral is appropriate. According to NHS guidance, fast-track CHC funding should be decided within 48 hours of the referral being made.

If your loved one does not qualify for CHC, they may still be entitled to a social care needs assessment through their London borough, which could lead to funded support or direct payments. Citizens Advice can help you understand the financial thresholds. The Age UK Advice Line on 0800 678 1602 is also very good on this, and they have no commercial stake in what you decide.

What good palliative care at home actually looks like

Beyond the funded routes, many families choose to supplement NHS and hospice care with a privately arranged carer. The shape of what good looks like here is fairly specific. You want continuity above almost everything else. One carer, ideally, who gets to know your loved one and the routines of the house. Not a different face every morning. Not someone who has never met the person they are caring for.

You want to meet the carer before any arrangement begins. Not after the first shift. Before. You want to know they have been independently DBS-checked and that someone other than you has verified their experience with complex or palliative care. And you want the relationship to be direct, so that if something changes overnight you are not navigating a call centre before you can reach the person actually in the house.

What families in this situation tell us they wish they had known is that it is possible to have that kind of arrangement. It takes a little more thought to set up than calling a large agency. But the difference in continuity and calm can be significant, especially in the final weeks.

We at Hibant are one option for families looking for exactly this kind of privately arranged, vetted, consistent carer in London. But whether you come to us or not, the shape above is what to hold out for in any arrangement you make.

One thing to do this week

If your loved one has not yet had a palliative care referral, that is the one call worth making tomorrow morning. Ring the GP surgery, say the words "palliative care referral", and ask what happens next. You are not giving up. You are opening a door. The Carers UK Helpline on 0808 808 7777 can also help you think through your own needs as a carer during this time. Both calls take ten minutes. Both can change what the next few weeks look like.

If you would rather not piece all of this together alone, this is exactly where Hibant can help. We are a London introductory care agency and we work with families who need a consistent, privately arranged carer alongside their NHS and hospice support. Every carer we introduce has been DBS-checked, insurance-verified, and reference-checked by us. You meet them in person before any arrangement begins, and you choose the person yourself. We have worked with families navigating palliative care at home and we understand the particular weight of it. If you want to talk it through with no obligation, you can email hello@hibantcare.com or visit hibantcare.com.

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