Ongoing psychosocial assessment and support and care of the patient and their relatives are extremely important as death approaches. However, provision may need to be adjusted according to the changing needs of the patient – many will experience increasing anxiety and distress, increased feelings of social isolation and, alongside this, a decrease in physical energy available to them for dealing with these concerns. Relatives will naturally be distressed by the increasing illness of the patient and may exhibit signs of grief even before death occurs. Nurses should ensure that, wherever possible, the physical environment is conducive to patients and relatives being able to express their thoughts and emotions, and that appropriately trained staff are available to listen and support them.