A British researcher from the University of Nottingham wrote in a paper that the home may not always be the best place to die for patients. This argument signifies that dying at home may not be as preferred as it was previously believed.
Place of death is said to be a contributing factor to the quality of end-of-life care. The most common notion is that people would like to die in their homes as institutional surroundings such as hospitals are not considered conducive as one passes away.
Medical expense issues may also arise, strengthening the appeal of death in homes.
Another point made is that the desire to die at home decreases with age and weaker health, and are said to be less significant among those diagnosed with diseases apart from cancer.
The different points made by different researches signify that the actual preference of patients in terms of their place of death remains imprecise and inconsistent.
The author of the paper named Kristian Pollock said that public surveys report that about two thirds of patients opt to die at home; however, the results vary in different surveys. Nonetheless, a significant finding among these documentations is that while people may choose to die at home, the place of death is not always the priority, as compared to the desire to die quickly, free from pain and distress.
Putting much thought on the place of death takes away the attention to the actual provision of quality care to patients during their last days of life.
When dying at home is set, a risk of not being able to carry out the plans well occurs. This promotes a sense of guilt and failure. Aside from that normatively recommending dying at home may put a patient in a situation where expressing other choices becomes increasingly challenging. Although they may be offered an option, they are expected to "choose wisely."
Pollack said that dying at home does not necessarily mean that a person died a good death. The individual may have passed away in distress, unsupported, scared or without anyone around.
Patients have also been noted to frequently express their desire to not be a burden to their families. The advantage of dying in fully-equipped hospitals with adequate professional support is believed to take away that burden.
When a patient decides to die at home, all efforts must be made to grant this; however, it must be remembered that as long as all the needed resources are in place, the expectations entailed in patient choice promotion may not be realized fully.
The safe and warm environment that the home has may be omitted as it is turned into a hospital outreach where visitors, home care personnel and medical equipment becomes inevitable.
Family members and the patient may also find it concerning to witness suffering and death at home, as well to connect their abode into a place of loss.
"Death at home is not necessarily good, and just because a patient did not die at home does not necessarily mean their death occurred in the wrong place," wrote Pollack.
With the possible influx of hospital deaths, institutions must come up with ways to reinvent their facilities in such a way that dying patients and their families receive the best quality care.
The paper was published in the British Medical Journal on Wednesday, Oct. 7.
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