Nurses caring for older patients across diverse settings will provide care for people with dementia approaching the end of their lives. Demographic changes mean that the number of people dying with dementia will increase, however nurses and other healthcare professionals may be unprepared to meet their needs. Factors that are essential to provide compassionate and dignified end of life care for people with dementia include effective communication with those with cognitive impairment and an awareness of likely causes of anxiety, fear and resistance to care when carrying out interventions. Accurate assessment and pain relief are required to ensure good end of life care. Knowledge of challenging and complex issues around maintenance of nutrition and hydration requirements, and communication skills to discuss the issues with families and carers are also required.