This symposium appealed to a wide variety of professionals. The importance of anticipatory care planning was consistently stressed as a key means of improving end-of-life care in the twenty-first century. Such planning can be difficult, not least because of the differences in illness trajectories and the problem of identifying dying. Various initiatives, frameworks and care pathways have been devised to aid this planning process. Lack of palliative care training and support compromises the quality of end-of-life care provided in many care homes. Symptom management is obviously important and, if associated with impaired renal function, frequently necessitates modifications to drug therapy. Patient narratives were demonstrated as an invaluable insight into the patient’s perspective. Discussions surrounding ‘do not attempt resuscitation’ (DNAR) decisions are often challenging, but new guidance has been produced. The day was closed with multi-professional case presentations debated by the panel of speakers.