While much of hospice care, from a medical professional viewpoint, is concentrated on the physiology and pharmacology of maximal symptom management in hospital or at home, families and those caring for the day-to-day aspects of dying face different barriers to care. Achieving an environment that is both the safest and the most efficient for care at home is not often considered and the elements of achieving that environment are the focus of this chapter. What general equipment needs, what 'nursing' skills and what practical advice can we give to families and care-givers who care for dying patients at home? It is important that physicians understand the details of home care planning and needs so they can provide the best counsel for patients and their families as they make choices about terminal care.