Is it always better to die at home?

[Jo Dirt]

I recently lost two patients. One to cancer and the other to COPD. It was known they were dying, and still, they would be sent to the ER with exacerbation of symptoms and neither of my patients came home this last time.

I was talking to a nurse who doesn't really think it is always such a good thing for the patient to die at home, as this can create more stress and isolated feelings for the family.

I know, of course, it depends on the family, but in general, what do you believe?

I'm not so sure I want to die at home, after the discussion we had. Maybe she is right?

[llg, PhD, RN]

Ilg, as I read your post it is apparent to me that your mother did die at home. Home, as I refer to in my posts, is not necessarily a physical

address, but home is wherever thy heart lies. God Speed!

Thank you for reading my posts with an open mind. Some people can't seem to imagine that an institution (such as a nursing home) can be a good place and can be seen as an integral part of one's community that is "home."

My family is very lucky that religious group has set up a beutiful, caring retirement community only a mile away from the small town in which I grew up. Many of our senior citizens retire there and lead active lives for many, many years. They live on the "campus" in independ housing. As they more assistance, other types of housing are available -- on the same campus. They can move into an apartment building, or asisted living, or a total care nursing home. The local Visiting Nurse Association leases space on the same campus for its local offices.

A community such as that offers the residents (and their families) great service and great peace of mind. All the resources are there to close-at-hand to help any resident that needs them -- all coordinated to help the senior citizen and the residents lead a high quality life up to the end of life.

My parents moved (about a half mile from their home) into that retirement community as soon as they hit age 65 -- as did many of their friends. I'll probably move there myself, someday. It's a nice place.

[Sue Damonas, BSN]

I took care of my mother for a number of years, dealing with all the complications of End Stage Cardiomyopathy. During the last hospital admission we knew where she was headed and brought her home on hospice. It was so hard on me with the endless Roxanol, etc, and sleep deprivation but she was so grateful to be at home. If I had to do it all over again I'd do the same thing because of what it meant to her.