Patient and family perspectives are vital in conceptualising quality of life in the dying (1). The principles of a 'good death' have been established (2,3), and multidimensional frameworks exist for understanding and evaluating end-of-life care (4). However, care often falls short of the ideal, or is offered late. To examine why, we set out to understand the holistic needs of 40 patients dying from lung cancer or cardiac failure and their carers, and to explore to what degree these needs were identified and addressed by service providers (5).