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Details can be found at: http://www.ucl.ac.uk/nicor/access.""End-of-life (EOL) care refers to care for people with advanced disease once they have reached a point of rapid decline, Telomerase typically the last few weeks or months before death.1 Similar to the approach of palliative care in general, EOL care largely revolves around maintaining the quality of life and comfort of the patient, and their family, through management of pain and other physical, psychosocial and spiritual morbidities, but focusing on the defined period of time before death.2�C4 Patients at EOL can have variable complex medical issues and tend to use a high proportion of healthcare expenditures; also, the intensification of care is often associated with poorer outcomes.1 5�C7 Accordingly, there is growing attention, globally, to enhance palliative and EOL care, especially in the home setting. Home is where most patients prefer to be cared for at EOL,8 9 and where care can be both high quality and more cost-effective.10�C12 As with palliative care, which should begin gradually and earlier in the illness trajectory, EOL care can occur in a number of settings, such as in the patient's home, as well as in hospital intensive and palliative care units, residential hospices and long-term care facilities. Each setting of care is organised and financed to deliver care differently, based on its service mandate, professional complement and the unique care needs of the populations served. Accordingly, the extent of EOL services offered in each setting also vary. It is, therefore, important to understand potential nuances in the defining elements of quality EOL care in different healthcare settings, and from a variety of perspectives, particularly from those with vast experience in this care. Several studies have explored the quality of EOL care from the perspectives of seriously ill patients, caregivers and families.13 These studies have identified broad lists of elements of quality.14�C18 For instance, a study by Heyland et al,17 in which 434 hospitalised terminally ill patients were surveyed about aspects of care, revealed five top concerns rated as extremely important: trust and confidence in the physician; not to be kept alive on life support; honest communication; feelings of completion; and not being a burden on the family. Yet, asking patients or family caregivers directly ��What matters most?�� only considers their individual viewpoints, at that point in time, which may be unique to the individual's preferences or change as the experience unfolds. Furthermore, much of this research has been conducted in acute care settings, such as hospitals or intensive care units, or long-term care facilities. However, less research has focused on defining quality when the patient is at home, in a non-institutional setting.