Good nutrition is important in caring for patients with life-limiting illness, not only for meeting the body’s physical requirements but also because of its associated social, cultural and psychological benefits. A decision to provide nutritional care and support requires an understanding of and respect for patients’ wishes, as well as an appreciation of their expectations and the benefits and burdens of such support. The patient, his or her family and healthcare professionals should openly discuss and agree the goals of nutritional care and support at an early stage, rather than waiting until patients are unable to discuss their preferences with family and carers.