[Video] 3 Things You Need to Know about Dying at Home

 We often meet with clients who are investigating whether or not it makes sense to stay in their current home or to move to a senior living community. In doing so, we find that some people are committed to remaining “at home” through the end at all costs. In other words, they absolutely do not want to move to a nursing community or go to the hospital should they or their spouse become ill. 

This sounds like a reasonable request, right? Well, it is, but there is more to this particular choice than one might think. 

Here are 3 things you need to know when it comes to “staying put,” being “carried out in a pine box,” or simply aging (and dying) at home.

Hospice 

As soon as you or your loved one qualifies for hospice services you should take full advantage of these services. They are 100% covered by Medicare and the hospice agency can also provide things like a hospital bed and other equipment. 

More importantly, your hospice nurse essentially replaces calling 911 when it comes to medical issues. Being “on hospice” means you have an entire team of people at your disposal. This might include nurses, nursing assistants or aids, social workers, chaplains, and others. Services are provided in your place of residence. 

Hospice provides support to the entire family and caregiving team. Unlike most medical service providers, the hospice team is there to help the family too. They provide education, guidance, counsel, and a listening ear. Upon the death of the patient, they also offer grief support and bereavement services. 

For those with a terminal illness, the frequency of nursing services and visitation by hospice staff members increases as necessary to keep the patient comfortable and pain-free. Rather than going to the hospital for these services, the hospice staff coordinates the necessary care in the home. 

Personal support system

In addition to professional support such as hospice, you will also need personal support. This means family, friends, or paid companions who can be there to help with day to day needs like meal preparation. 

A common myth is that hospice provides “everything.” Hospice provides a lot, but their services are designed to compliment the personal care provided by family and friends. In the absence of this support, paid caregivers (non-medical companion care) can be a substitute.

Estate planning documents

Having estate planning done in advance of any medical issue or crisis is important, but even more so if you plan to die at home. In the absence of written and legally binding instructions, healthcare providers are required to perform life-saving treatment if called to your home. 

We have known for a spouse or other family member to “panic” when the end is nearing and call 911. The fire department or ambulance service arrives and if the patient is in distress or unconscious, they will proceed according to their protocols. This likely means taking you to the hospital. 

If you do not have a legally binding DO NOT RESUSCITATE order accessible (and visible), they must continue with life saving treatments. Even if your family says, “He doesn’t want to die in the hospital,” they must take you. The DNR is your “stay out of the hospital” card. If enrolled in hospice, the hospice workers will help you understand and fill out this form, as well as place it in a visible location - just in case. 

If you plan to avoid the hospital at all costs, there might be other legal documents you will want to have in place as well, so talk with your estate planning attorney about your intentions. 

NOTE: “Home” might mean your personal residence (a house, condo, or apartment), an independent living community, assisted living, memory care, or longterm care facility.

Another note: We REALLY dislike the word “facility” and prefer “community,” but unfortunately, that is what most people still use when referring to residential healthcare settings.

If you need more information about local hospice providers, estate planning attorneys, or in-home care services, feel free to call or email us. We can provide you with names of reputable vendors to consult with as you plan.