Once we realized our mom was not going to recover from aspirated pneumonia at age 91, my sister wanted to take her home from the hospital to die where she had lived for the last 15 months. She had been moms caretaker since her stroke 3 years ago, which left mom with some vascular-related dementia. First, mom was in a beautiful and expensive nursing home, but sis felt she could do a better job and make moms money last longer so she took her into her own home.
I was scared to bring her home rather than to the nursing home, worried that we wouldnt be able to correctly monitor moms pain meds, or that it would be too crowded and hectic for hospice, my two sisters, me, and my nephews. But I am so glad we did bring her home.
We joined a growing trend of providing an at-home death for a loved one: the percentage of patients dying at home increased from one-sixth in 1989 to one-fourth in 2007, according to a report by the National Center for Health Statistics. About 40 percent of terminally ill patients still die in the hospital, and 28 percent of those over 65 die in nursing homes. But the availability of hospice care has allowed more adults as well as children to die at home in the last two decades. Medicare-certified hospice agencies in 2008 increased 20-fold since 1985.
The trend toward dying in place, at home, became evident to me while researching my book, says Karen Jones, author of Death for Beginners: Your No-Nonsense, Money-Saving Guide to Planning for the Inevitable. Jones found that the suspicion boomers held towards the government and anyone over 30 has turned to the medical institutions, their aggressive frantic end-of-life treatment of patients and the money they make from it. She found this to be true across social, political, and economic divides. There was a palpable distaste for dying in a hospital and most held the view that death at home with loved ones in a peaceful situation was what they wanted for themselves and their parents.Moms at-home death meant that we could be with her round-the-clock, without interruptions from hospital staff. During her first hours at home, hospice showed us how and told us when to administer liquid morphine and Ativan to make moms restless arms more comfortable and her labored breathing less painful. We took turns sleeping on the couch beside her hospital bed set up in the living room. She was unable to open her eyes, and aside from her trouble breathing and restless arms, seemed to be asleep. But the literature told us that hearing is the last sense to go so we continued speaking to her, telling her what was happening and beginning to let her go, although we had wanted her to live to see the spring flowers in April and May.
We were prepared that it might take a week for mom to pass, but she slipped away on her third day at home. My caregiving sister and momscertified nurse assistanthad washed mom that morning and dressed her in her own nightgown. I was sitting with mom, saying silent prayers and stroking her arm, when her eyes suddenly opened and then closed as she took her last breaths. I hope mom knew that she was cared for by her darlings, as she called us right up to the end. We were lucky we had the time to bring mom home and be with her. But perhaps she could have come home even sooner. Studies show that doctors are still reluctant to discuss end-of-life care with patients and their families, tending to stick with what they do best, which is to treat patients. Studies also show that family members who bring their loved ones home to die are less traumatized by death than those who watch helplessly in a hospital.I am no longer scared of the prospect of taking care of another family member at home when their time comes. But what will happen to me? I dont live near family and Im not sure my landlord would want a tenant dying on the property. Will boomers form care buddy groups to take care of each other in spaces they share? It wont happen unless we start talking about it. What do you want to do?Judy Kirkwoods mother remains an inspiration to her.
