Where Can I Get End-of-Life Care?
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Decades ago, most people died at home, but medical advances have changed that. Today, most Americans are in hospitals or nursing homes at the end of their lives. Some people enter the hospital to get treated for an illness. Some may already be living in a nursing home.
There is no right place to die. And, of course, where we die is not always something we get to decide. But, if given the choice, each person and/or his or her family should consider which type of care makes the most sense, where that kind of care can be provided, whether family and friends are available to help, and how they will pay for it. In this article, we explain some of the care options available to people at the end of life.
In a hospital setting, medical professionals are available who know what needs to be done for someone who is dying. This can be very reassuring. In addition to the regular care team, some hospitals may have palliative care teams that can assist with managing uncomfortable symptoms and making medical decisions for patients who may or may not be at the end of life.
More and more people are in nursing homes at the end of life. In a nursing home, nursing staff are always present. Unlike a hospital, a doctor is not in the facility all the time, but may be available by phone. Plans for end-of-life care can be arranged ahead of time, so when the time comes, care can be provided as needed without first consulting a doctor.
If the person has lived in the nursing home for a while, the staff and family probably already have a relationship. This can make the care feel more personalized than in a hospital. Additionally, if the person is enrolled in hospice, the hospice team will be available to assist nursing facility staff with end-of-life care.
As in a hospital, privacy may be an issue in nursing homes. You can ask if arrangements can be made to give your family more time alone when needed.
Home is likely the most familiar setting for someone who needs end-of-life care. Family and friends can come and go freely. Care at home can be a big job for family and friends—physically, emotionally, and financially. But, there are benefits too, and it is often a job caregivers are willing to take on. Hiring a home nurse is an option for people who need additional help and have the financial resources.
Talk with your healthcare provider about the kind of care needed. Frequently, this care does not require a nurse but can be provided by nursing assistants or family and friends without medical training.
To make comfort care available at home, you will have to arrange for services (such as visiting nurses) and special equipment (like a hospital bed or bedside commode). Health insurance might only cover these services or equipment if they have been ordered by a doctor; make sure you check with your insurance company before ordering.
Work with the doctor to decide what is needed to support comfort care at home. If the seriously ill person is returning home from the hospital, sometimes a hospital discharge planner, often a social worker, can help with the planning. Your local Area Agency on Aging might be able to recommend other sources of help.
A doctor has to be available to oversee the patient's care at home—he or she will arrange for new services, adjust treatment, and order medicines as needed. It is important to follow the doctor's plan in order to make the dying person as comfortable as possible. Talk with the doctor if you think a treatment is no longer helping. Hospice is frequently used to care for people who are home at the end of life.
For More Information About Where to Get End-of-Life Care
Content reviewed: May 17, 2017