Introduction. Both population and patient surveys have shown that most cancer patients would prefer to die in their own home. However, only a quarter of cancer deaths take place at home. Family strain has been identified as one of the main reasons for patients being admitted to a hospice to die. Little is known about how best to support families to enable them to continue to support patients at home. Methods. As part of a qualitative study investigating how and why decisions to admit are made we explored factors contributing to family strain. A qualitative case-study approach was adopted. Five hospice homecare patients who died at home and five who died in the hospice were randomly selected. Semi-structured interviews were conducted with seven of the main informal carers some five months after the death. All professional carers involved in the patient's care (GPs, district nurses, hospice homecare and ward staff) were invited to participate: 45 did so. Interviews were transcribed, coded and between-and within-case analyses conducted. Results. Most informal carers had found caring for their relative at home fulfilling but stressful. Anxiety was provoked by a lack of preparatory practical information and advise on recognising and dealing with common symptoms. Some felt that they would have found it easier to carry on caring if they had been given more information on when death was likely to occur. Advice on how to recognise when someone had died was to also needed to reduce unnecessary uncertainty. Conclusions. These findings highlight the gap between lay and professional knowledge of how to provide practical nursing care, of the meaning and control of common symptoms, and of the signs of approaching death. Health professionals need to ensure that they give carers the information they need to reduce their anxiety and enable them to feel more in control of their lives at this difficult time. Greater recognition of the chasm between lay and professional knowledge, together with more effective ways of bridging the gap, may be needed if more families are to be enabled to continue caring for their relatives until death.