Discuss the benefits and consequences of dying at home

What will be an ideal response?


When asked where they would prefer to die, 80 to 90 percent of Americans say "at home." The reason is clear: The home offers an atmosphere of intimacy and loving care in which the terminally ill person is unlikely to feel abandoned. However, only about one-fourth of Americans experience home death. And it is important not to romanticize dying at home. Because of dramatic improvements in medicine, dying people tend to be sicker or much older than in the past. Consequently, their bodies may be extremely frail, making ordinary activities—eating, sleeping, taking a pill, toileting, and bathing—major ordeals for informal caregivers. For many people, the chance to be with the dying person until the very end is a rewarding tradeoff for the high demands of caregiving. But to make dying at home feasible, adequate support for the caregiver is essential. A specially trained home health aide is usually necessary—a service that hospice programs have made more accessible. Still, when family relationships are conflict-ridden, a dying patient introduces additional family strains and is subjected to increased distress, negating the benefits of home death. Furthermore, even with professional help, most homes are poorly equipped to handle the medical and comfort-care needs of the dying. Hospital-based equipment and technical support often must be transported to the home. For all these reasons, older adults—although they view home as their ideal place to die—express concerns about quality of care, about burdening family and friends, and about the need for adult children to engage in unduly intimate caregiving tasks. And 10 months after a home death, family members continue to report more psychological stress than do family members whose loved one died elsewhere.

Psychology

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