Most people, when asked, indicate that they would prefer to die at home. Home represents familiarity, the presence of loved ones, and a sense of connection with ongoing life. In the last 50 years in Australia and many parts of the western world however, the number of people who die at home has actually decreased. However, only around 16% of people die at home. Around 20% of people die in hospices and 10% in nursing homes. The rest die in hospitals.

Some life-limiting illnesses such as cancer can lead to a sharp decline in function requiring intensive care. Other diseases such as cardiac disease or chronic obstructive pulmonary disease may not see such a predictable pattern of decline. Death may occur unexpectedly or even during treatment in hospital. Managing some symptoms may also require intervention and skilled nursing support.

Home caregiving can be very demanding particularly, if the primary caregiver is older or has other commitments such as a job or a young family. Equipment and other items to help caring may also change how your home looks. However, caring at home can also be rewarding for the patient, caregiver and family.

Being aware that an illness cannot be cured can provide patients with more choices in end-of-life care, including staying at home. When we think about where we would like to be cared for it worth remembering that over time, attitudes to our preferred place of care and preferred place of death may change. Place of death is an important part of planning for patients and family and it is a discussion that may need to be had on a number of occasions as circumstances change. This can be a useful part of advance care planning to make sure that your wishes are understood and respected.

This page was created on 22 April 2008
Last updated 26 May 2008