Twenty-five years of involvement with a multidisciplinary oncology unit and being with dying patients from the inception of disease till death have given me a rich understanding of their needs and expectations. While physical needs and pain often dominate the discourse around death, caregivers need to acknowledge the equally significant but less obvious psychological, spiritual and existential concerns that affect patients’ emotional well-being as they progress towards death. Understanding patient needs and expectations in the framework of physical, psychological, social, spiritual and existential needs may enable caregivers to organise the necessary support and interventions that will facilitate a dignified process of dying.