Background There has been a significant increase in the life expectancy of people with intellectual disabilities. As a result, they experience life-limiting chronic conditions that require end of life care. Understanding their needs is paramount to providing exemplary end of life care.

Aim To explore the importance of maintaining familiarity for people with intellectual disabilities at the end of life.

Method A constructivist version of the grounded theory approach was adopted. Individual face-to-face, semi-structured interviews were conducted with 11 adults with intellectual disabilities. The data were analysed using the constant comparative method.

Findings Maintaining familiarity at the end of life was essential to provide safety and comfort for people with intellectual disabilities. They wished to preserve their everyday routines and be cared for at their usual residence by familiar carers.

Conclusion People with intellectual disabilities wish to receive end of life care at their usual residence from people they know. Therefore, service providers must consider appropriate strategies to accommodate their needs and wishes.