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What is VSED?

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• Voluntarily stopping eating and drinking (VSED) is when a mentally capable adult chooses to hasten their death by refusing all food and fluids.

• It is not usually experienced as painful; thus, the focus is on comfort, calm, and symptom relief.

• It is a conscious, intentional, and informed decision.

• It is lawful in the UK when chosen by an adult with mental capacity.

• It normally takes place at home (sometimes in a hospice if they support such a choice).

• Death usually occurs within one to two weeks, depending on health, hydration status, and other factors.

• It can be a choice for people with an incurable illness, advanced frailty, or experiencing unbearable suffering from a chronic or progressive illness(es) who wish to avoid further decline.

• Support from health and social care professionals should be obtained.

• It should involve Advance Planning for End of Life, including an Advance Decision to Refuse Treatment (ADRT) and an Advance Statement to ensure the person’s wishes are respected if they later lose capacity.

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Facts vs Myths

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For an overview, see here.

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Lawfulness

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In the UK, an adult who has the mental capacity to make decisions has the legal right to refuse food and fluids, even if that decision may lead to their death. VSED is when someone makes this choice deliberately.

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This choice is lawful. It is not assisted dying. No one is causing the person’s death. The law recognises that people have the right to decide what happens to their own body, including the right to refuse eating and drinking.

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It is also lawful for family members, partners, friends, and others in a person’s close support network to respect the person’s decision, to remain present and offer companionship, and to provide comfort, care and emotional support.

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Doctors may lawfully palliate symptoms should the need arise. This was established in a Decision of the Supreme Court of the United Kingdom (SCUK).

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What You Need to Know About Health and Care Professionals​

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In the UK, there is no single national clinical guideline on VSED for health and care professionals. Advocacy and some end-of-life charities note a lack of formal UK guidance, which can leave healthcare professionals uncertain about how best to support a person considering or undertaking VSED.

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We believe access to medical support is necessary to ensure that a person choosing VSED receives appropriate medical care if the need to palliate symptoms arises. At present, UK health and care professional bodies do not have clear, consistent, or comprehensive statements specifically addressing VSED.

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Regardless of the absence of national guidelines and considering the statements of professional bodies, our view is that health and care professionals should hold in mind the following key principles:

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• People have the legal right to refuse food and fluids, even if this may result in death.

• Health and care professionals must respect a person’s autonomous decisions, provided the person has mental capacity.

• When a person chooses VSED, professionals should continue to offer care, comfort, and symptom relief. If they feel morally unable to do so, they should not abandon the person and instead make arrangements for alternative support and care.

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Our experience of a person speaking to professionals about VSED is mixed: some are supportive and willing to engage, while others may be unfamiliar with VSED or hesitant due to uncertainty or lack of guidance. ​If you have been asked to advocate for a person close to you or are liaising with health and care professionals on their behalf, you may find yourself in the position of having to educate health and care professionals about VSED, including providing factual information to address objections rooted in misunderstanding or risk aversion. A calm, patient, and sometimes tenacious approach may be required here.​

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You may wish to look at the information we have provided for Health and Care Professionals.

 

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Why People May Choose VSED

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Health Reasons

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People choose VSED for different reasons. Broadly, there are two common situations:

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1. Some people choose VSED because they are already suffering in ways that feel intolerable to them.

2. Others choose VSED to avoid what they fear may be a difficult or distressing final phase of life and to retain a sense of control before their condition worsens.

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This may include, for example:

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• Someone living with a progressive or terminal illness who has decision-making capacity

• Someone whose independence has been greatly reduced by frailty or long-term health problems, and who has decision-making capacity

• Someone with suspected or diagnosed early stages dementia, fearing a prolonged death from advanced dementia, who has the mental capacity to make the decision to VSED

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An important distinction: VSED is a deliberate end-of-life decision made by a person who has the mental capacity to make this choice. It is different from anorexia or other eating disorders, where not eating is part of a diagnosed clinical condition that affects a person’s relationship with food and their ability to eat. Those situations involve very different needs and require specialist assessment and treatment. VSED is also different from stopping eating and drinking due to a diagnosed psychiatric disorder, which again calls for appropriate clinical care and support.

 

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Purposeful Choice

 

People who consider VSED are rarely motivated by a single emotion. More often, the decision emerges from a deep inner process shaped by personal values, lived experience, and a desire for peace at the end of life.

 

A wish for control and agency
Many people fear losing autonomy, becoming dependent, confused, or unable to express their wishes. VSED can feel like a way to remain an active decision-maker in the face of an uncertain future.

 

Avoiding feared suffering
Some people are less afraid of death itself than of what may precede it: unmanaged symptoms, prolonged decline, or loss of dignity. VSED may be seen as a way to step away from a future that feels intolerable to them.

 

Preserving dignity and identity
For many, dignity is closely tied to identity, how they live, how they relate to others, and how they are seen. VSED can feel like a way of ending life in a manner that remains true to deeply held values.

 

Relief from emotional and existential distress
Living with ongoing illness, frailty, or the anticipation of deterioration can carry heavy emotional weight. Choosing VSED may bring a sense of relief, not because life has lost meaning, but because the struggle has become too much.

 

A wish for a calmer, more predictable ending
For some, VSED offers emotional reassurance: time to say goodbye, to put affairs in order, and to die in a way that feels quieter and more contained than repeated crises or medical interventions.

 

It’s not necessarily about giving up on life
Emotionally, VSED is usually about how someone wants to die, not a rejection of life itself. Most people remain deeply connected to relationships, meaning, and love right up to the end.

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What the VSED Dying Process May Look Like 

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The length of time it takes to die by VSED can vary significantly from person to person. It depends on factors such as the individual’s underlying health, e.g. whether they are already frail or seriously ill, their physical reserves, and their hydration status. Where the person ceases the intake of food and fluids from the outset, the VSED process takes on average 7-21 days, most commonly 10-14 days. There is no predictable or guaranteed time frame.

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A person undertaking VSED may approach the process in different ways. Some people stop all food and fluids completely from the outset. Others choose to gradually reduce their intake of food and drink over time before stopping altogether.

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For some people, this tapering approach can feel more manageable or comfortable than stopping abruptly. Gradually reducing intake can allow the body and mind to adjust to the change. Reducing food intake in advance of stopping to drink may also allow the digestive system to slow down naturally. When a person chooses to taper, they will stay hydrated for longer and thereby lengthen the VSED process. 

 

Dying by VSED generally follows a pattern that is similar to other natural dying processes. The body gradually slows down, energy reduces, and the focus of care is on keeping the person as comfortable and settled as possible.

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VSED is not usually experienced as painful. Some discomfort can happen, such as a dry mouth, weakness, or restlessness, but these are usually manageable with good care and support.

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Not everyone experiences every part, as described below, in the same way.

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Early Days

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In the first few days, the person will usually be awake, aware, and able to talk with those around them. They may still enjoy company and conversation.

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You might notice:

• Hunger at first, which usually fades after a few days

• A dry mouth rather than strong thirst

• Tiredness and less interest in activity

• More time resting or lying down

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Middle Period

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As the body becomes weaker, the person may sleep more and have less energy. They may be awake for shorter periods.

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You might notice:

• Increasing weakness and fatigue

• Longer periods of sleep

• Less need to pass urine

• Occasional confusion, restlessness, or seeing things that others don’t​​

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Final Stage

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Towards the end, the person may become mostly unconscious and no longer able to communicate.

 

You might notice:

• Little or no response to voices or touch, though comfort from familiar presence may still be felt

• Changes in breathing, such as pauses or shallow breaths

• The body gradually shutting down

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This stage is similar to the final phase of many other deaths.

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Some of the changes described at each of the stages can be unsettling to witness, but they are a common part of the dying process and can usually be eased with comfort-focused care.

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Two particularly vivid and informative descriptions are available through It's My Right: The Handmade Death of Herta Sturmann, a video recording of her dying and death, and through Choosing to Die, a book in which Phyllis Shacter recounts her experience of accompanying her husband at the end of his life.

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Where VSED Might Take Place

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At Home

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All our personal experiences of being alongside someone during VSED in the UK have been in the home environment. Many people choose to VSED at home, where surroundings are familiar, and those important to them can be close by. Being at home can offer privacy and a sense of control at the end of life.

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It is important to have access to medical support during the VSED process, should it be needed. This is usually arranged through the person's GP (for more information, see here on the page for individuals considering VSED). Having GP involvement means that comfort-focused medications can be prescribed if required, helping to manage symptoms such as agitation, pain, or distress. GP involvement also makes it easier to access out-of-hours medical support and visits from community nursing services and hospice at home, which can provide additional reassurance and practical help for both the person choosing VSED and those supporting them.

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Considerations for the home environment include space and facilities. The space where the bed is located should feel calm, safe, and suitable for extended care. It needs to be large enough for carers to move around easily while remaining quiet and private. Ideally, there should be comfortable seating and a nearby place for a carer or family member to rest or sleep overnight, as a continuous presence is important in the later stages of VSED. Soft lighting, good ventilation, and easy access to a bathroom can help. 

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Care Home or Nursing Home

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We do not have direct experience of someone being supported during VSED in a care home or nursing home in the UK. Where this possibility has been raised, we have encountered predominantly negative responses, often linked to concerns about reputational risk and perceived legal or safeguarding implications. In principle, it should be possible, and there may be examples of this occurring that we are not aware of. In practice, however, it may not be a feasible option in many care and nursing home settings. 

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We do not want, however, to rule out with a blanket statement that it is never possible, and a request can be made to a care or nursing home where the person feels they would want to be supported, should they choose to pursue VSED.

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Hospice

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There are some publicly known examples where a person has been supported in a UK hospice. Hospices differ in their familiarity with VSED, and decisions about involvement are usually made on a case-by-case basis. Our understanding is that some hospices will only consider supporting a person to VSED when they have a terminal diagnosis.

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Access to inpatient hospice beds is often limited, which can affect whether this is a realistic option. Some hospices may feel unable to offer inpatient care in these circumstances.

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Hospice-at-home support may be an option to explore, but responses can vary depending on a hospice’s experience and its resources.

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The usual first step in general to access hospice support is to speak with the GP, who will make a referral to the person's local hospice. However, contact can be made with the hospice directly first to understand their position and what support may be possible. 

 

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Hospital

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Our understanding is that VSED is least commonly supported in hospital settings. Hospitals are often busy and focused on active treatment, which may not align well with a person’s wish for a peaceful death.

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Reflective Questions When Asked for Support

 

Things to consider about yourself before offering support

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If you have been asked for support by a family member, friend or person close to you who is considering dying by VSED, it is important to think about yourself. Before offering any form of support, it is essential to take time to consider whether you feel comfortable with the request, and whether this is something you genuinely wish and are able to be involved in.

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Support for someone considering VSED could range from providing a space for an open conversation to being alongside the person. 

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You may find that you are unable or unwilling to provide support for ethical, emotional, relational, or practical reasons. This is okay. Being asked to support someone considering VSED is a significant request, and declining to support or offering a reduced level of support that feels manageable for you does not mean you are uncaring or unsupportive.

 

If you decide to offer support, it should be done freely and without pressure. It is also important to recognise that this can become a substantial commitment, and that once support is given, it may be difficult to withdraw without causing distress. Taking time to reflect at the outset helps protect both you and the person who has asked you for your support.

 

It may help to consider:

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• What kind of involvement, if any, feels possible for you?

• What boundaries would you need to put in place?

• What support might you need for yourself if you were to be involved?

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Key things to understand about the person seeking support

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If someone has asked you to support them, it is important to take time for open, honest, heart-to-heart conversations. The prompts below are offered to help you listen deeply and understand their perspective, their circumstances, and what they may be hoping for from you.

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These are not questions to work through all at once, nor a checklist. They are offered as areas for gentle exploration, at the person’s pace, and only where it feels appropriate.

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​Someone choosing VSED may wish to record their reflections in a written statement that can be shared with others and included within their Advance Plan. We also suggest that they record a short video summary of their reflections, if they feel comfortable doing so. This can help make their wishes clearer to others and reduce misunderstanding or uncertainty.

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Understanding what is their driving wish

• How do they describe their life as it is now, and what makes it feel intolerable for them?

• What changes or losses do they anticipate in the future that influence their wish to die by VSED?

• What experiences, information, or observations have shaped these expectations?

• How do they describe that they feel their life is completed and that continuing no longer feels right for them?

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Their understanding of VSED

• What do they understand about dying by VSED, including what the process may involve and where there are uncertainties and challenges?

• How long have they been considering VSED as a possible option?

• Is this something they see as one option among others, or as the only option available to them? What speaks for and against the option of VSED for them?

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Conversations and support around them

• Who else, if anyone, have they spoken to about their wishes (family, friends, close network)?

• How have those conversations gone, and do they feel heard and respected?

• Have they spoken with a medical professional about their wish to die by VSED, and what response did they receive?

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Timing, urgency, and flexibility

• Does this feel important to them now?

• Are there specific symptoms, fears or future losses that make them feel they wish to pursue VSED in the near term?

• What are they?

• Or are they seeking to name VSED as a future option, while leaving the timing open or undefined?

• What circumstances, if any, might lead them to reconsider or change their mind?​

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What support are they hoping for?

• From your family, friends and close network

• From privately arranged paid carers

• From health and care professionals

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Role as a supporter

• What kind of support are they hoping for from you — listening, practical help, advocacy, presence, personal care, or something else?

• What feels possible and appropriate for you to offer, and where are your own limits or boundaries?

• Have they asked anyone else for support? How do you feel about supporting alongside this person, and could you coordinate support with them?

 

A Note on Support:

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Our experience is that VSED should not be undertaken alone and that a person needs to be supported through the process.

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As the process progresses, weakness and fatigue increase and everyday tasks can become difficult. Having someone present means there is help with basic practical needs such as safely moving and avoiding falls, mouth care, and taking prescribed medication. It also means that if symptoms become uncomfortable, someone can contact healthcare professionals to seek appropriate support.

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Should the person's wishes be questioned by professionals or others, a trusted person(s) being present can help ensure that their decision and planning are understood and respected.

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In terms of support, we recognise that family can mean different things to different people. It may include relatives, close friends, neighbours, and links with people in community groups. We also recognise that some people may not have a close network around them for such reasons as bereavement, geographical distance, estrangement or other personal circumstances and are instead reliant on formal services and/or privately arranged paid carers.

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Planning and Practicalities

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Careful planning and practical preparation are central to VSED. They help ensure the comfort of the person choosing VSED is prioritised, reduce the risk of unwanted medical intervention, and support those caring for them, including professionals, in understanding and respecting your wishes. We have outlined some of the key aspects below.

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Advance Plan

People who are considering or who wish to plan for VSED should record their wishes in an Advance Plan while they have mental capacity. Two documents are particularly relevant: an Advance Decision to Refuse Treatment (ADRT) and an Advance Statement.  We go into more detail here.

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Mental Capacity 

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VSED relies on a person having the mental capacity to refuse food and drink, so having a mental capacity assessment is very important. More information can be found here.

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Care

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We have assumed that VSED will take place in the home setting. It is important to recognise that as the VSED process progresses, continuous (24/7) care and presence will usually be needed.

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• Who will be involved in providing care — for example, informal carers such as family and friends, paid carers, an end-of-life companion? Do they support the person's decision to VSED?

• How will each person be involved in the person's care, and what will their role be?

• How will carers be informed about the decision, to ensure clear understanding and commitment to the agreed plan?

• If paid carers and/or an end-of-life companion are required:

  • What will they be expected to do?

  • Is there a budget in place to support this?

• Practical considerations for carers:

  • Carers should avoid cooking in the house, where possible, to reduce food smells.

  • Where will carers be able to rest or sleep during overnight or extended support?

• Has a discussion with the GP taken place so that they know that the person intends to VSED?

• Has the GP agreed to provide support, for example, by providing a “just in case” box/bag/pack? The box/bag/pack allows health professionals (GPs, district/community nurses, out-of-hours doctors) to manage symptoms promptly, without delays caused by pharmacies being closed.

• Has the GP put a copy of the person's Advance Plan (including the Advance Decision to Refuse Treatment (ADRT) and Advance Statement) on the medical records?

• Is there a do not attempt cardiopulmonary resuscitation (DNACPR) or ReSPECT form in place? 

• In the context of VSED, ensuring the GP is aware of the person’s situation and is able to visit is particularly important. A GP visit within the last 28 days of life usually enables the GP to certify that it is an expected death, meaning referral to the coroner is not normally required unless other concerns arise.

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Working as a Team​

 

When someone is considering VSED, it can be helpful to think about the circle of people who may support them. This may include doctors, community nurses, paid carers, and people in their close network.

 

Where several people are involved, good coordination can make a significant difference. It helps maintain continuity of care, highlights any gaps in support that may need to be addressed, and enables everyone involved to understand the person’s wishes and work together in a joined-up and consistent way.

 

Being connected also means that those supporting a person during VSED can also support each other in what is often a stressful and emotional time period.

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Speaking on the Person's Behalf​

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It is important to establish who the person choosing VSED would wish to speak on their behalf if and when, as will happen at some point in the VSED process, they are no longer able to speak for themselves. Who holds this role and responsibilities should be agreed upon in advance and understood by everyone involved in the person's care. The person(s) they choose must fully understand their decision, respect their wishes and preferences, and be willing to uphold them throughout the process.

 

This can be an emotionally demanding role, particularly at a time of heightened stress with the anticipation of death and vulnerability for all involved. If you should be asked by the person choosing VSED to speak on their behalf, consider carefully if you feel that you are able to act as their ally and advocate with health and care professionals.

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Important points to explore include:

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• Are there one or more Attorneys appointed under a Lasting Power of Attorney (LPA) for Health and Welfare (or Power of Attorney in Scotland)?

• Is there clarity and confidence that the Attorney(s) understand and will support the person's decision to VSED?

• Who will be the lead decision-maker(s) and coordinator in relation to the person's overall care?

• Who will be the lead person(s) responsible for supporting and communicating decisions relating specifically to the person's refusal of food and drink?

• Who will take responsibility for advocating on the person's behalf with health and care professionals?

• Do all those involved in the person's care hold the Advance Plan, including an Advance Decision to Refuse Treatment (ADRT) and an Advance Statement?

• Does the person have a DNACPR or ReSPECT form or a Treatment Escalation Plan, and do all those involved in your care know how to access the document?

• Does the person wish for medical information held by their GP, consultant, or hospital to be shared with other named people (family member, friend, close network)? If so, they will need to provide written consent for their information to be shared.

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Timing and Commencement

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It is important to clarify how and when the person wishes to start VSED.

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• The proposed start date

• Whether the person wishes to:

  • Stop eating and drinking immediately, or

  • Taper food and fluids over a short or longer period (for example, reducing over a few days before stopping completely)

• Are there any substance dependencies that need to be considered and planned for in advance (for example, alcohol, nicotine, or other substances)?

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Medications

 

• Are there any life-prolonging medications the person would wish to stop?

• Are there medications they would wish to continue, particularly those that provide comfort or symptom relief but do not prolong life?

• Have anticipatory (“just in case” box/bag/pack) medications been discussed and arranged through the GP, hospice, or palliative care team?

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Affairs in Order

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A person's affairs being in order means that their legal and financial documents and administrative matters are organised and recorded, so there is no undue burden for those left to access, manage, and sort things when you the person has died. See checklist here.

 

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Comfort Care

 

Comfort care is the non-medical care given to help someone feel as comfortable, safe, and supported as possible as they approach the end of life. It includes gentle bodily care, emotional support and reassurance, as well as creating a calm, peaceful, and familiar environment. At its heart, comfort care is about kindness, presence, and responding with care to what matters most to the person in that moment.

 

If you are involved in supporting the person and want to know more about comfort care, see our guide here.

 

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Logistics

 

Practical and logistical arrangements need to be made. See checklist here.

 

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Supplies Needed

 

It is helpful to gather certain supplies before VSED begins. See checklist here.

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Advance Planning

 

Advance Decision to Refuse Treatment & Advance Statement

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There is a summary relating to this here.

 

When a person has chosen to VSED, we believe it is essential to have an Advance Plan (sometimes known as a living will) in place that includes an Advance Decision to Refuse Treatment (ADRT) and an Advance Statement. This documentation should be shared with the person's close network, health and care professionals and placed on their medical records. Together, these documents help make the person's wishes clear and guide decision-making. They clearly record refusals and wishes in their own words, so there is no uncertainty about what is wanted or why. Please note that different arrangements apply for ADRTs and Advance Statements in Scotland and Northern Ireland. The benefits of those documents are:

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• They help prevent confusion, crisis decision-making, unwanted interventions, or emergency calls that go against the person's wishes.

• Making the person's choices clear removes a burden on those involved in their care. As they know about the person's wishes, they won’t be asked to decide on the person's behalf.

• They should be shared with GP, nurses, carers, and other health or care professionals and the person's close network. This ensures everyone involved in their care understands their wishes and can focus on comfort and reassurance.

• They make clear that choosing VSED does not mean stopping care — comfort, presence, and compassionate support continue throughout.

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In short, an Advance Plan protects the person's wishes and supports those in the close network to act with clarity, confidence, and compassion at a difficult time.

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Advice and guidance on Advance Decisions to Refuse Treatment (ADRTs) and Advance Statements is available on the Compassion in Dying website.

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Specific wording relating to VSED for inclusion in an ADRT and Advance Statement is still evolving and has not yet been tested in practice or case law. However, we can share wording we've seen previously used in this context and support a person to explore this further, should they wish to make contact.

 

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Emergency Care/Treatment Plans

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An emergency treatment plan, such as a ReSPECT form or do not attempt cardiopulmonary resuscitation (DNACPR) decision, is important for anyone considering VSED. The applicable form depends on the person's geographical location and is completed in consultation with a health professional. It helps ensure that the person's wishes are understood and respected if their condition changes or an emergency arises.

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Having this placed on their medical records reduces the risk of unwanted or inappropriate interventions, such as emergency hospital admission or attempts at resuscitation, which may be contrary to their expressed wishes. A DNACPR or ReSPECT form tells emergency services not to try to restart the heart or breathing and helps them to respect it if the person's wish is to remain at home.

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For more information on DNACPR decisions, see here, and for ReSPECT, see here.

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What is Mental Capacity?

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We have frequently referred to mental capacity. When someone chooses VSED, an important question is whether they have the mental capacity to make that decision.

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Having mental capacity means the person is able to:

• Understand what stopping eating and drinking involves

• Recognise that this decision will lead to death

• Think through and weigh up their options

• Communicate their decision clearly, in words, writing, or other ways

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If a person can do these things, they are regarded as having the capacity for this decision, even if others feel uncomfortable or disagree with their choice.

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Making this choice does not mean the person lacks capacity
A decision can feel very difficult or upsetting to others and still be a valid, capacitated decision.

 

Capacity can change over time
Someone may have capacity now but not later. This is why it can help to talk openly and record wishes early.

 

Capacity is not about age, illness, or disability
People who are frail, living with serious illness or in the early stages of dementia may still have the capacity to decide about VSED.

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Mental capacity assessments

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Assessing capacity for VSED is typically conducted by qualified health and care professionals and independent, expert mental capacity assessors. Accessing a formal mental capacity assessment is not always straightforward. A person’s GP is usually the first point of contact, but in practice, they may not always feel able to undertake the assessment. Where this happens, people may need to consider approaching an independent, suitably qualified and reputable mental capacity assessor.

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If you would like to know more about mental capacity, here is the link to the Code of Practice for the Mental Capacity Act (England & Wales), which explains how the Act should be understood and applied in practice.  There are different versions for Scotland and Northern Ireland. 

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After Death

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The Citizen Advice Bureau provides useful information here, and you can also refer to the Gov UK website here.

 

Practicalities

 

After death, there are practical and administrative steps that people in the close network may need to undertake, often at a time when emotions are high and energy is low. The person who has died may have nominated one or more people for these tasks and there may also be an Executor(s) named in the person’s will who will be involved.

 

Contacting a healthcare professional to verify the death 

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Calling the GP surgery, community nurse, or palliative care team if involved. Outside normal hours, contact the out-of-hours GP service or NHS 111.

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They will:

• Verify the death

• Explain what happens next

• Advise when to contact a funeral director

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In the context of VSED, a GP visit within the last 28 days is particularly important. Where the GP has recent knowledge of the person’s condition and decision-making, they are usually able to certify the death, meaning referral to the Coroner is not normally required unless other reportable concerns are present.

 

Contacting a funeral director

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• This does not need to be immediate 

• The funeral director will arrange the transfer of the body and guide you through the next steps

• The person may have left instructions for their funeral

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 Registering the death

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• The Medical Certificate of Cause of Death (MCCD) is completed by the GP or doctor

• The GP surgery usually sends this electronically to the register office or tells you when it is ready

• The death normally needs to be registered within 5 days

• Contact the local register office

• Provide basic details about the person who has died

 

Funeral directors can often help with this process if asked.

 

Informing others

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Letting others know – including family, friends, acquaintances, neighbours, and executors to the will.

 

Who not to call

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Do not call 999 unless the death was unexpected or you are specifically advised to do so.

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Taking Care of Yourself

 

From our own experience, we offer these suggestions in the hope they may be helpful. We recognise that supporting someone during VSED is a very personal process, and everyone will find their own way of navigating it.

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While the person is alive and undertaking VSED

 

Supporting someone who has chosen to undertake VSED can be emotionally and physically demanding. Taking care of yourself is an important part of being able to support the person well.

 

You may experience a wide range of feelings: sadness, uncertainty, tenderness, moments of deep connection, anticipatory grief, anxiety, or feeling emotionally stretched. These responses are entirely normal.

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Talking with trusted friends, family members, or others involved in the support circle can help ensure you are not carrying the experience alone.

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Try to take regular breaks, rest when you can and maintain simple routines such as eating, sleeping, and spending some time outside the immediate care environment. Even short periods away can help you return with greater steadiness.

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It can also be helpful to remember that the decision to undertake VSED belongs to the person themselves. Your role is to accompany them, support them and respond to their needs rather than to carry responsibility for the decision.

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Being attentive to your own well-being allows you to remain present, compassionate, and grounded during a time that can be both challenging and deeply meaningful.

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After the death

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In the first hours and days

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After a person has died, there may be some practical matters that need attention quite soon. This can feel overwhelming, especially when you may also be experiencing shock, sadness, or exhaustion. 

 

It can help to have a simple checklist of immediate things that may need organising. You do not need to manage all of this on your own. Asking others in the person’s support network to help with practical tasks can make a real difference. Some people may be able to make phone calls, contact others, or help organise practical arrangements. Sharing these responsibilities can reduce the immediate pressure and allow you space to be with your own feelings and the significance of the moment.

 

In the immediate period after the death and following, it can help to focus on very simple things:

 

Allow your body to settle.

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Drink water and try to eat, even if only small amounts of simple food.

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Rest or sleep when you can, even briefly.

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Breathe slowly; your body may have been in a state of vigilance for some time.

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Try to reduce pressure on yourself. You do not need to explain or justify the death to anyone. It is acceptable to limit contact or delay conversations if that feels easier. Many practical tasks can wait unless they must be done.

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When the caring role ends

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After a period of intense accompaniment, carers often experience:

 

• A sudden sense of emptiness or loss of purpose

• Exhaustion once the focus of care lifts

• Feeling untethered or disoriented 

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Helpful steps can include keeping days simple and gently structured. If work or family responsibilities make this difficult, it may help to schedule small periods of quiet or rest. Where possible, try to avoid making major decisions immediately.

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Allow yourself to grieve in your own way and in your own time. This may involve spending time in nature, being with people you feel comfortable around, or allowing yourself periods of distraction when grief feels overwhelming.

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Emotional responses after VSED

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You may notice a range of emotional responses, including:

• Relief that the person died in the way they had chosen

• Sadness, numbness, or shock

• Replaying conversations or decisions

• Worry about how others might view the death

 

These reactions do not mean that anything was done wrong. Supporting someone through VSED can involve carrying a great deal quietly, and emotions may surface gradually.

 

Physical responses after VSED

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Grief after VSED can also show up in the body. You may notice:

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• Fatigue, headaches, or physical tension

• Disturbed sleep or vivid dreams

• Difficulty concentrating or remembering things

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Support

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It may help to talk with someone who understands VSED and will not judge the circumstances of the death. This might be another person who knew about the decision and respected it, or someone who was involved in the support circle.

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You may also find it helpful to choose carefully who you share details with. Protecting your emotional space is allowed.

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Some people find comfort in quiet practices such as writing, walking, sitting in nature, or creating small personal rituals to mark the death.

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In the weeks and months ahead, additional support may be helpful.

 

Some people find that supportive therapies can help with physical and emotional restoration.

 

Bereavement support can be valuable even when grief feels complex or difficult to explain. Peer support with others who have accompanied someone through VSED can also reduce feelings of isolation.

 

The following organisations may be helpful:

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AtaLoss

https://www.ataloss.org/bereavement-services

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The Good Grief Trust

https://www.thegoodgrieftrust.org/

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