We all face death eventually, but how we think about it is personal. How can understanding our mortality shape the way we live? Here, palliative care doctors and death doulas share what they’ve learned about the end of life—and how it influences their daily choices.
Put people first, not things
Dr Rachel Clarke, a palliative care doctor at an NHS hospital in Oxfordshire and author of several books, including The Story of a Heart, says: “I’ve learned what truly matters to my patients as they near the end. All the unimportant stuff falls away. No one cares about how much power they had, how big their house was, how fancy their car was, or their status at work. What they care about is the people they love.” In short: “The way to live a rich and deeply fulfilling life is to build human connections. That matters more than anything else.”
Repairing relationships can be vital at the end of life, says Dr David Holland, a palliative care consultant in Norfolk. “People often have things they want to say, like ‘I’m sorry,’ ‘I forgive you,’ ‘Forgive me,’ ‘I love you,’ or ‘Thank you.’ Leaving those feelings unspoken can lead to regret.”
Keep work in perspective
“If something is important to you, do as much of it as you can,” says Holland. “In my life, I truly value my work. It builds me up as a person, knowing I can connect with others and make a difference in their lives. It’s a real privilege.”
But it’s important not to get too wrapped up in your career, says Ruby Love, an end-of-life doula in Bristol. “I’ve never met someone at the end of life who regretted not working more or earning more money. If we can find a balance between what we need to live on and what we need to be happy, that’s key.”
Know that pleasure isn’t everything
“Pleasure is a very surface-level experience,” says Clarke. “It can be a distraction: you can eat or drink yourself into a stupor and have a great time, but it won’t give you a sense of fulfillment.” Deeper experiences matter more, she adds. “Those are the moments of joy, awe, and wonder at the world around us.”
Connect with nature
Working with dying people can be emotionally draining. Holland finds relief by tending a piece of land. “I’ve always been fascinated by wildlife and biodiversity,” he says. “I really enjoy being outdoors and helping things grow.”
Clarke adds: “The richness of life comes from our connections with other living beings—human and non-human. It could be animals, birds, or plants, but it’s living ties to the wider world that give life meaning. The more you invest in those connections, the more likely you are to feel deep contentment and happiness.”
Live with intention
“Most of my life, I focused on living without regrets,” says Tan Ming Li, an end-of-life doula in Singapore and founder of the Life Review, a charity that helps normalize conversations about death and dying. But one day, someone told her: “If you have no regrets, you’re not living life fully—you’re not daring to try things, just playing it safe.” That made Tan rethink. “Now, my philosophy is more about living with intention. If I get invitations, I ask myself: do I really want to do this? If tomorrow were my last day, how would I want to spend it?”
Focus on the small things
Tan says the secret to a well-lived life is “not just about joy, but what lights you up.””a fire in your belly.” For example: “I have a dog and I love grooming him,” says Tan. “It’s not easy and it takes a few hours. Could I have spent that time doing other things, which might be seen as more productive by society? Of course.” But she values this time with her dog and would never send him to a groomer.
“Value those small moments, like when the leaves first come back on the trees in the spring, or when you have a really good cup of tea,” says Love. “The big things are wonderful, but most of our life is made up of small things. So try to appreciate them.”
Be a completist
People often think about their legacy at the end of their lives, says Holland. “I’ve had people who have wanted to hand over something important. This could be a business, memories, or the building of a house.” So finish that novel, sort out your family albums, and get your affairs in order.
This year, Love arranged an exhibition for a client who used to be a photographer: “It was very small and low-key, but it was something she really wanted to do.”
Connect with others
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‘Knowing you can make a difference is a real privilege.’ Photograph: Luis Alvarez/Getty Images; posed by models
Clarke advises asking yourself: have you been part of something that connects you to the people around you? “That could be through charitable work, working as a teacher, or being a loving figure at the centre of your family. It could be through artistic or creative effort. It could be a craft you love doing and giving to your friends.”
Holland says he values “running a kids’ football team, having an input in village life, and building relationships with neighbours.”
Don’t worry about signs of ageing
“The wrinkles, grey hairs, and menopausal body that I now have are all things society wants us to feel distressed about, because they want to make money selling products to fix our distress,” says Clarke. “All those stigmas linked to ageing are actually a blessing and a privilege. Anyone old enough to feel anxious about these things should be saying: ‘I am so lucky. I have lived long enough to creak when I get out of bed in the morning.’ These are things many people are not fortunate enough to experience.”
Try to stay healthy – but don’t let it limit your life
“The doctor in me makes me want to look after myself,” says Holland. “But at the same time, I see many patients where medical issues happen for no reason we can identify. So it’s important not to get too hung up on things and remember that life is for living. Time is precious.”
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‘Living connections with the wider world give our life meaning.’ Photograph: Halfpoint Images/Getty Images; posed by a model
Clarke says: “It’s incredibly important to try to live healthy lives so we can function as well as possible for as long as possible. But equally, ascetic lives are pretty hard and constrained. That’s the opposite of life. Life is something to savour.
“So, try to be healthy, but don’t beat yourself up for things often seen as minor sins of living, like eating delicious food and drinking beautiful wine. We are sensual creatures, and celebrating that is part of living life richly.
“I see health in the broadest sense, and that includes enjoying life, not just living it for as long as possible.”
Celebrate birthdays
If someone has a terminal diagnosis, Tan recommends having a living funeral, where people gather to celebrate someone’s life with them before they die. “It doesn’t have to have the word funeral in it; just have a party. I want balloons and wine and people I love to be with me,” says Tan.
If this doesn’t sit comfortably with you, or you are in good health, Tan advises making sure you celebrate birthdays, especially the big ones, as youYou’re getting older. Love has worked with clients who wanted a living funeral, but for others, that can feel overwhelming, especially when they’re very unwell: “If you can’t face a big event, spending time with people in smaller groups or one-on-one is a way of doing that.”
Have a bucket list – and make it happen. “I have about 100,000 things I want to do and experience before I die,” says Clarke. Seeing otters in the wild has been a long-time dream. “I was recently on holiday with my family in Northumberland, dutifully visiting nature reserves and empty coastlines, trying to spot otters, but they still managed to avoid me. However, I did get to see and walk among thousands of nesting puffins. That was almost as wonderful as I imagine seeing my first wild otter will be.”
Holland says: “The time when people are really ill is important, because knowing life is limited allows memories to be made and legacies to be left.” What’s on his bucket list? “My son and I always talk about going to Costa Rica and seeing lots of wildlife.”
View image in fullscreen: ‘A good death happens when someone is at peace with the life they’ve lived.’ Photograph: Tom Werner/Getty Images; posed by models.
And Love? “I would like to have a baby. I’d love more time in nature. I want to get really good at making focaccia.” She suggests focusing on achievable, regular goals: “That way, if you suddenly face an accident or a terminal diagnosis, hopefully you won’t have a long list of things you’ve never done.”
Talk about the kind of death you’d like. “A good death happens when someone is at peace with the life they’ve lived,” says Clarke. “And they feel at peace with who they’ve been, the actions they’ve taken, and above all, the relationships they’ve had with others.”
What kind of end of life does Clarke hope for? “My fantasy is to be a 90-year-old woman who’s still engaged and fiercely commenting on how she thinks the world should be, but also enjoying a glass of champagne with her grandchildren and stubbornly going out at 5am trying to spot an otter.”
Love says: “We tend to avoid thinking about these things, especially younger people and those in good health. But actually, if we plan now for all the possible scenarios, we can then put those plans away and focus on living. And then, if or when a situation comes up where those plans are needed, they’re already there, and we don’t have to make decisions when everyone’s stressed or when communication becomes harder.”
Does she have an end-of-life plan in place? “I’m in my early 30s and I’m starting to do my own planning. My work has taught me that you have to make the most of what you have every day. So go see your friend, do something fun – because life isn’t infinite.” Do you have an opinion on the issues raised in this article? If you’d like to submit a response of up to 300 words by email for possible publication in our letters section, please click here.
Frequently Asked Questions
Here is a list of FAQs based on the insights shared by endoflife experts on living well
General Mindset
1 Why are endoflife experts the ones giving advice on how to live
They spend their final days with people who are looking back on their lives This gives them a unique perspective on what truly mattered what was wasted and what people regret not doing They see the finish line so they know the best route to run the race
2 What does embrace your wrinkles actually mean in practice
It means letting go of the exhausting pursuit of looking young Its about accepting your age and the physical signs of a life lived rather than fighting them Its a shift from valuing appearance to valuing experience health and the freedom that comes with not caring about superficial judgments
3 Why is celebrating birthdays so important
Its not about the cake its about the acknowledgment Experts say that many dying people wish they had celebrated their life more instead of dreading getting older Every birthday is a milestone that many people dont get to see so marking it is a way of saying Im glad Im still here
4 How does not letting work consume you lead to a better life
When people are dying they almost never say I wish I had spent more time at the office They regret missing family events hobbies and quiet moments Work provides purpose but it shouldnt be your entire identity Experts suggest treating work as a part of your life not the whole of it
Practical Application
5 Im in my 30s Is this advice relevant to me or just for older people
Its the most relevant for you The habits you build nowlike setting boundaries with work and practicing gratitudebecome your default as you age Its much easier to embrace your wrinkles if you start valuing your worth beyond your looks or your job title before you lose them
6 What is a concrete way to start celebrating birthdays if I usually ignore them
Start small Throw a dinner party for your closest friends take the day off work or write a list of things you accomplished in the last year The goal is to make the day feel distinct and special
