This case study is an example from practice whilst working in a nursing home setting, and it will describe how a holistic approach to care provided to a resident, suffering from dementia at end of life, ensured a peaceful death. The importance of advance care planning and effective pain and symptom management in end of life care will be explored. The psychosocial issues experienced by the resident and their family and any ethical issues associated with the delivery of care will be addressed. The factors and challenges that need to be overcome, in order to ensure effective pain and symptom management for the dying patient, particularly in a nursing home setting are discussed. Finally, this article will make recommendations for future practice.