|There are more people in the US who are dying at home than there are deaths in hospitals—a first in more than half a century / Photo by: Photographee.eu via Shutterstock|
There are more people in the US who are dying at home than there are deaths in hospitals—a first in more than half a century. This is considered as a "remarkable turnabout" in Americans' view of so-called "good health," as per The New York Times.
The observation is found in a report published in the New England Journal of Medicine, in which researchers examined the number of natural deaths in the US based on data from the Centers for Disease Control and Prevention (CDC) and the National Center for Health Statistics (NCHS).
Natural death was defined as death due to a medical condition, meaning people died from illnesses or conditions rather than an accident.
Increased Deaths at Home
In the analysis of the death data from 2003 to 2017, the researchers found that the number of hospital deaths is still high although it is declining. Results show there were 905,874 deaths recorded in hospitals in 2003 (39.7% of overall deaths), but that number plummeted to 764,424 (29.8%) in 2017.
The decline of hospital deaths was parallel to the increase in deaths at home, from 543,874 (23.8%) in 2003 to 788,757 (30.7%) in 2017, according to CNN, an American news-based pay television channel, adding there was also an increase in deaths at hospice facilities. In such facilities, a team of professionals from various specializations addresses a patient.
CNN says this team works to help ease the patient's pain and physical needs, manages their mental and spiritual concerns, and helps the family.
The number of people who died in hospice rose to 212,52 (8.3%) in 2017 from 5,395 (.2%) in 2003. This increase in hospice death came as the number of deaths in nursing homes declined, from 538,817 (23.6%) deaths in 2003 down to 534,714 (20.8%) in 2017.
Cancer patients have the highest chance of dying at home or in hospice, the analysis said, while people with dementia are likely to die at a nursing home. People who suffered from a stroke had the lowest odds of dying at home compared to other patients.
The increased number of people dying in hospice care means that more people seek the help of professionals in these facilities. But despite that rise in use of such facilities, CNN says other studies have demonstrated that hospice care is underutilized.
Dying at Home Is Good News
Earlier studies also found that even though insurance like Medicare can cover up to six months of hospice care, most people are more likely to turn to it days before their deaths instead of months. There are also certain hospice programs that allow people to stay at home instead of bringing the patients into their facilities.
Haider Warraich, the associate director of the Heart Failure Program at the Boston VA Healthcare System, told Reuters, an international news organization, that these programs are the key reason why deaths at home have become increasingly common.
"More people dying at home is good news," Warraich said in an interview, noting that it is aligned to what the patients want.
"If you ask patients or loved ones where they would like to pass away, regardless of where you are or how sick you are, home is the number one choice. Being able to die at a familiar place becomes very important for many patients, even if it’s for a single day."
He added that this preference should "catch the eye of policymakers" who should determine how the healthcare industry can provide more resources so people who wish to die at their homes can do so. This recommendation comes as the findings suggest the need for shifting the focus of the healthcare system away from end-of-life hospital care.
Warraich believes that if given better support and the ability to offer additional services, hospice programs would help persuade more people to die at home.
|Earlier studies also found that even though insurance like Medicare can cover up to six months of hospice care, most people are more likely to turn to it days before their deaths instead of months / Photo by: Arne Beruldsen via Shutterstock|
Honoring People’s Wishes
The increase in at-home deaths is also a reflection that the healthcare industry is able to honor people's wishes to pass away in a place familiar to them. But not a lot of people are so lucky to have this choice.
It's less common for younger patients to die at home, according to the study. NBC News says this is likely because of two reasons: "young people in life-threatening situations are more likely to undergo emergency medical interventions in a hospital, and insurance other than Medicare may not cover hospice care."
The news agency adds that this is the same for racial minorities; the reasons are likely due to disparities in access to healthcare or cultural preferences. Dying at home is at lower odds for women as well, considering they are more likely to become the caregiver than men.
Aside from being in a familiar space at the end of their life, patients may prefer dying at home because of "the degree of control that you and your family have over how things are going to happen," said associate professor Harleah Buck, who was not involved in the study.
There is a variety of cultural and spiritual needs related to death that usually involves a large gathering of family members, said Buck, noting that these needs won't be met in a hospital room. Most hospitals also have strict limitations on young children and pets as visitors.
However, preferring to stay at home during a patient's last days also raises the concern of how well caregivers are supported when they are thrust into the role carrying out medical tasks. It's at these instances that hospice care can assist not only in comforting patients but also acting as their informal caregivers.
It's important to give the people the opportunity to choose the way they go in the space they would like and with the people they love.