Taking dying patient home with children - what are your thoughts?

Specialties Pediatric

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I was reading a SW's note on a patient recently and read about the family's refusal to take patient home because they have little children. I am encountering more and more people these days who want to shield their children from seeing death/dying.

I am a huge proponent of providing hospice care at home, allowing people to die in their own bed, surrounded by their family. Not in a hospital. Not in a nursing facility. And so, I am saddened by this situation.

When I was little, I remember my aunts taking care of my dying grandmother at home. I remember her vacant stare, a tube from her nose, the deep, gasping breaths. It was strange to me, but I was not scared or anything. I feel like we underestimate children a lot. I think kids can take it. Even learn an important lesson about life that way.

What do you think? Would you feel comfortable letting your children see a family member dying, or do you think dying person should be kept away from children?

I think the decision is bring a hospice patient into a home with children...

is a personal one and needs to be left to the family.

In my case.. it would depend on the age of the children, and how I perceive they would be affected by the situation.

Specializes in ICU.

This is a very personal decision that shouldn't be judged by others. What works for one family may not work for the next. I can see both sides of the fence. I've also been a home hospice nurse.

Sometimes for for a child, depending on the age, it could be very difficult for them to associate their living room of the house they live in with the death of a parent.

If it was me, dying, I would make my decision upon the personality of my child and what I personally felt would best for them in the long run.

Specializes in Hem/Onc/BMT.

How did this get moved to Pediatric Nursing section? Hmm... I suppose my question does involve psychosocial aspect of children even if they're not patients themselves per se.

Thank you everyone for such thoughtful responses and some very personal experiences.

I absolutely agree there should not be any judging whatever the family's choice may be. I just think that the idea that having a dying person is too scary for children is unfounded and over-protective. Children are curious by nature and very receptive, accepting things at face value. It's we, adults, who teach them that death is a scary thing, that dying is... abnormal, something that should not be. As several posters mentioned, people died at home all the time in the old days, with very little consideration for the effects on children. Were they all traumatized and forever scarred? I don't think so. It was just accepted as a part of life. Even if they get scared at the time or even traumatized, they will gain perspective as they get older, just like they grow out of most childhood nightmares.

By the way, when I went back to work this morning, I learned that this patient in question died during previous shift.

Specializes in Emergency and Critical Care.

you hit the nail on the head, education and support in whatever the family is comfortable with. I gave earlier my own personal opinion. As a nurse we have to support the patient but more often than not it is the family we are giving the most support too.

Specializes in Peds/Neo CCT,Flight, ER, Hem/Onc.
Such is this culture... I am glad I wasn't brought up here. I will NEVER let my parents even step on the parking lot of nursing homes. It's really sad, this country.

Funny, after caring for their ill parents at home, mine have almost begged me to put them in a "nice home" when the time comes. They don't want to put their children what they went through. Will it happen that way, I don't know but I'm really grateful that my parents have released us from the guilt we might have felt if we find we cannot care for them at home.

Specializes in Hem/Onc/BMT.
Funny, after caring for their ill parents at home, mine have almost begged me to put them in a "nice home" when the time comes. They don't want to put their children what they went through. Will it happen that way, I don't know but I'm really grateful that my parents have released us from the guilt we might have felt if we find we cannot care for them at home.

My mother is the same way. She insists she'd rather go to a nursing home than living with me if she became too sick to live by herself. While I would rather avoid such scenario as much as possible, I wouldn't write off the possibility. We just don't know how things will work out in the future. But that is a topic for another thread.

Aside from our own consideration, how would the presence of little children affect your decision to take in an ailing parent? If I had my own children and I wanted to keep my mother (or my husbands parents) at home when she is at the last stage of her life, it would not make a difference in my decision. People may think it's cruel to the children. I don't know. I will do my best to alleviate their fear if I need to, but ultimately, they will get over it.

Specializes in Labor/Delivery, Pediatrics, Peds ER.
Funny, after caring for their ill parents at home, mine have almost begged me to put them in a "nice home" when the time comes. They don't want to put their children what they went through. Will it happen that way, I don't know but I'm really grateful that my parents have released us from the guilt we might have felt if we find we cannot care for them at home.

This happened in my family as well. My mom and her siblings shared the care of her mother late in life. At that point, she told me she never wanted to "force" this on us and she wanted to go to a nursing home when the time came. Many times, especially toward the end, I wanted to bring her here but she always refused.

I think it would have been hard on her here, also, since our youngest with special needs was just too active for her to deal with. It was a much noisier and active environment than she was used to dealing with. She would tire easily when we were around too long. I think if she ever reconsidered her decision, she probably considered also that the environment wasn't exactly restful. I felt badly that I didn't get to spend time having her here and caring for her as she lived several hundred miles away from me, but that's the way she wanted it.

You really cannot judge the situation as there are way too many factors. I get the response in theory (that shielding kids from death is a bit much) but in actuality there are just so many more variables. In the end, it's what the patient and their family want. Not everyone wants the same thing.

I like America. I'm proud of this wonderful nation. I was born and raised here. I love my country warts and all.[/quote']

Needless knee-jerk nationalism like this gives me the creeps.

Specializes in Skilled Nursing/Rehab.

My father in law knew for about 2 weeks that he was dying, and he wanted to die at home. His wife, my mother-in-law, did NOT want him to die at home because if he did, she would have been "scared to be in the house alone after that." I disagreed with her decision, but at the same time, I am not her, and I can never fully understand what goes on inside her. My father-in-law died in a hospital, surrounded by his kids and his wife. My mother-in-law stayed in their home for about 8 or 9 more months, then moved "to town" where 3 of her children live.

I guess this response is not about children, but about how each person's response to and attitude toward death are different. I was somewhat angry (inside, did not express it to her) with my mother-in-law for not allowing her husband to die at home, but hey, he is gone and she is the one who had to live in the house after he died. I agree with the idea that maybe these parents just weren't comfortable with having the child die at home, and having small children was the easiest reason to give. I naturally have more empathy for the dying person, but as a nurse I believe my responsibility would be to support the entire family in their decisions.

This is the one thing that makes me wonder if I would be able to handle hospice. I am comfortable with the idea of people dying and have a desire to ease their way, but I have more empathy for the dying person than for the family, and in hospice you have to care for both.

Specializes in Nursing Professional Development.

As others have said, there is no "one right path" that is correct for everyone. The culture of my family is move to a retirement community at some point (located in our home town) ... and then into the nursing home section of that same community when that level of care is needed. For us, that is the best way to handle those sorts of things and we would be offended by some outsider suggesting that there was something wrong with our family because of our culture.

We don't want our family members to take care of our intimate physical needs and would prefer that professionals do those kinds of things. For us, it is an important aspect of maintaining our dignity.

We also don't want to be a burden for our family. We want to be free to continue living full lives even if we may linger and have a lengthy period of needing assistance. Again, that is an important part of maintaining our sense of self-respect and dignity.

Finally we take a sense of personal pride at having made those arrangements for ourselves -- taking care of ourselves and not burdening our family with arrangements and difficult decisions. My family talks openly about such things and we trust each other to handle things in accordance to our beliefs when the time comes. It's not an unnatural fear of death ... or unloving act ... to utilize the services of professionals during advanced infirmity and/or the death process. It can be as caring and loving as any other cultural practices.

Such is this culture... I am glad I wasn't brought up here. I will NEVER let my parents even step on the parking lot of nursing homes. It's really sad, this country.

Well, I'm sorry but some families have no other choice but to put their LO in a nursing home.

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