In his book, The Good Death Guide, Michael Dunn states that a hundred years ago, most people died at home. As recently as the 1950s, twice as many people died at home compared to modern-day society. There are a number of reasons for these changes but as far as possible, people who are frail or have terminal sicknesses should be allowed a choice of where to die when their time comes.
The Decision to Die at Home
In past years, most people died at home. Family units were closer-knit and relatives were expected to look after each other. As signs of impending death showed, family and friends would gather to say goodbye and hold and touch the sick person. There was no fear in this and it was regarded as part of the process of life. The benefit to the dying one was the closeness and support of family and the comfort of being in familiar surroundings.
In recent years, there was a strong shift to transferring terminal patients to hospital if death was imminent. Nowadays there seems to be a reversal of this trend and many cancer patients request that they be allowed to die at home.
Dying in a Hospital
People often end up in hospital because their condition is life-threatening and family members may not have the time to care for their needs. While medical care is instantly available, there are disadvantages to dying in a hospital. These include the following:
- Families and communities are shielded from the death process and may fear it.
- Death changes from a natural event to a medical failure.
- Many people die alone as loved ones are called too late.
- Hospitals are generally cold and impersonal and offer little privacy.
Dying in a Hospice or a Residential Care Home
These are often home substitutes and although they may offer a higher level of compassion and emotional care than a hospital, they can still be impersonal. However, they can be a good substitute when it is impossible for a person to die at home. The staff are normally focused on helping the person and their loved ones through the lead-up to death and the grieving that follows. The rooms may be homey and the person is often allowed to bring familiar items with them.
If a person is dying from cancer or another terminal disease, it is a good idea to ask them where they would prefer to spend their last days. In some cases, it may be possible to hire a nurse to help at home and administer medications. If a hospice is an option, ask for recommendations and visit several before making a decision. It is important that the wishes of the dying person be considered and adhered to as closely as possible.