Background A significant proportion of older people state a preference to die at home. However, the vast majority of people in hospital recognised as dying subsequently die there. Objectives To identify the proportion of older people dying in hospital where the possibility of ending life elsewhere was explored. To identify factors that could support hospital staff to enable patients' wishes to be met. Methods Retrospective case-note review of 100 older patients (>75 years) who died during 2009 in an English Hospital.