Death is an inescapable part of life. Yet for many people death involves a prolonged struggle to put off the inevitable, many times at the cost of their quality of life as well as substantial financial costs. The emotional benefits of choosing to die at home are significant, although those choosing this option will likely need more support from family and friends than those who choose to die in a hospital.

The choice to die at home

Generally speaking, those people who die at home do so in a more peaceful manner than those who die in a hospital. Further, although their level of physical pain is about the same as those who die in a hospital, the emotional pain experienced by their relatives is less. These findings correlate with the fact that the majority of people would actually prefer to die at home as opposed to in a hospital or other healthcare facility.

Factors involved in choosing to die at home

A recent study in the United Kingdom showed that more than nine out of ten people who, when given a choice, decided to die at home shared at least one of four different factors: the preference of relatives of the dying person; the desires of the dying person themselves; involvement with home palliative care (such as a hospice program) within the last three months of the person's life; and the receipt of district or community nursing within the last few months of life. Further, an increased number of home visits by a doctor increased a patient's chance of dying at home.

Other considerations that were shown to have a correlation to a person's chances of dying at home were: the amount of time the patient's family had been aware that the patient was suffering from an incurable condition (this of course gives rise to increased acceptance); whether the patient had discussed his or her desire to die at home with his or her family; and the amount of time family members of the patient had taken off from work in the last three months of the patient's life.

One of the authors of the study noted that these findings should prompt an exploration into whether providing increased access to in-home services such as palliative care may be a worthwhile endeavor. When these services are unavailable then it stands to reason that at least some people who would prefer to die at home will end up dying in a hospital instead, resulting in an increase in emotional costs as well as financial costs.

Further, because many families of dying people would prefer to be able to remain at home with their loved one and provide care to him or her during his or her last days, some governments should consider whether to implement a form of employment insurance benefit--similar in function to maternity leave--to allow for this to occur. While this might seem at first glance to represent an increase in spending, when the lower financial costs of dying at home are taken into consideration this may actually represent an opportunity for an overall saving in healthcare costs.

Conclusion

Most people, when given the option, would prefer to die at home rather than in a hospital. There could be any number of factors for this, including a sense peace and rest that one derives from being in a familiar situation. A recent study showed that those who die at home experience a greater level of peace and satisfaction than those who die in institutionalized settings. Further, the grief experienced by the loved ones of these patients is lower than the grief suffered by loved ones of patients who die in a hospital.

Given this, it may make sense to determine whether our society should provide more options to allow people to die at home. These options would include an increased availability of palliative care services as well as some sort of employment insurance benefit to allow the family members of dying patients to remain at home with them and provide care during their last days.

Sources

Medicalnewstoday.com (website). Dying at home leads to more peace and less grief, but requires wider support. Available at http://www.medicalnewstoday.com/releases/300752.php. Last visited October 22, 2015.

Barbara Gomes, Natalia Calanzani, Jonathan Koffman and Irene J. Higginson. Is dying in hospital better than home in incurable cancer and what factors influence this? A population-based study. Available at http://www.biomedcentral.com/1741-7015/13/235. Last visited October 22, 2015.

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