End-of-life care is critical support and medical help for persons during the time surrounding their death. Although most people would prefer to be at home at the time of their death, many elderly persons do not die at home. Despite numerous palliative care and hospice programs being available, barriers to death at home still exist. It is crucial to discuss the remaining barriers that prevent older people from dying at home.
Several factors contribute to death at home not being provided for older patients. Family members are highly likely to become caregivers to their older relatives. However, they often lack the knowledge and experience to provide the necessary care, leading to patients being transferred to hospitals (Wahid et al., 2018). Lack of information on the end-of-life care available to their family members is another barrier to achieving death at home. Wahid et al. (2018) note that health care professionals may fail to mention whether the patient nearing death is eligible for any palliative care programs. Depending on the condition of the patient, the family may struggle to reorganize the space at home or lack financial care to provide at-home care (Wahid et al., 2018). Moreover, one of the primary barriers to death at home is difficulties recognizing death and failure to prepare for one’s death (Wahid et al., 2018). Specifically, people may feel uncomfortable discussing their death or the death of their loved ones and delay the conversation and discuss one’s preferences regarding dying. Thus, advance care planning is not considered often, leading to patients; preferences not being known and respected.
In summary, death at home, although a preference for many, is not always provided for patients. Dying remains a sensitive subject, and many people are not prepared to initiate the conversation about their death, translating into their wishes not being fulfilled. Furthermore, the inability of family caregivers to provide adequate care and the failure of medical professionals to refer them to end-of-life and hospice care programs can lead to patients dying at the hospital rather than at home.
Reference
Wahid, A. S., Sayma, M., Jamshaid, S., Kerwat, D. A., Oyewole, F., Saleh, D.,… & Payne, S. (2018). Barriers and facilitators influencing death at home: a meta-ethnography. Palliative Medicine, 32(2), 314–328.