Jim lacks capacity to make decisions about discharge and is being transferred to a care home. However, Jim wants to stay in hospital to be cared for by people he has become familiar with. The healthcare staff talk to Jim in a calm way about the decision and about what is happening. They are engaged with Jim and show empathy and understanding of his situation, acknowledging his distress, but are honest about what is going to happen. The staff are trying their best in a difficult, real life situation. However, getting it completely right is not always possible and the repeated reminders of an earlier conversation about care home may have added to Jim’s distress. The staff themselves find this is a distressing situation to be in.