Kangaroo Island is the third largest island of Australia and the largest island off the coast of South Australia. A cross-sectional survey was conducted of professional carers and closest caring person of 15 patients who had died of malignant disease between 1994 and 1996. There was a high level of satisfaction with services provided on Kangaroo Island. There was regret about over-optimistic prognoses being given by specialist medical practitioners and considerable dissatisfaction with the service provided by tertiary hospitals. A divergence in assessment of symptoms was revealed between carers and professionals. There is need for improved training opportunities for community nurses, improved financial support for families dealing with malignancy and a need for more formalized bereavement services.