The success of the health system means people are living longer, but potentially also with longer and more complex trajectories at the end of life. Not only will there be more deaths as the baby-boomers reach the end of their lives, but deaths are projected to occur at much older ages. This research, commissioned by the Ministry of Health, uses linked national data for all deaths occurring and registered in New Zealand in 2015. Mortality data is linked to the Cancer Registry, hospitalisations, inpatient procedures, emergency department events, outpatient visits, pharmaceuticals, laboratory tests, disability support services, primary care capitation, aged residential care subsidies, interrail assessments and data from hospices and hospital palliative care. Five distinct trajectory groups are identified, with different utilisation of services. Daily place of care and transitions in care are explored over the last three years of life. Projections to 2043 have been produced as well as health system costings for the last years of life. From a policy perspective, the results show the extent of dementia and the need for aged residential care. This has implications not only for the health system, but also retirement policy, and for the support of family carers.