Dying at Home

A growing number of people choose to live their final weeks or months at home. For patients who cannot benefit from acute care in the hospital, home care offers an alternative to a nursing home or hospice. Advances in medical technology and pharmacology allow even those with serious illnesses to remain at home relatively free of pain and symptoms, and professional services are increasingly available to assist family caregivers with work that is often physically and emotionally exhausting. First published in 1991, Dying at Home examined the reasons behind this trend and offered practical advice about assuming as much control as possible over the process of dying. In this thoroughly updated edition, medical anthropologist and gerontologist Andrea Sankar keeps her focus on the patient and loved ones while providing the latest information on hospice home care teams, pain medications, HIV and AIDS, legislation on death with dignity, physician-assisted suicide, and sources of information and support for patients and families. Dying at Home is an intimate account based on extensive interviews with family and professional caregivers as well as with other family members, friends, and patients. The author addresses the concerns and problems of those who face the decision of whether to care for a dying loved one at home, including preparing the home environment for caregiving; how to use professional caregivers in the home setting; managing the patient's pain, agitation, and other conditions; and how to recognize impending death and what to do immediately after death. She draws from stories that represent a wide range of circumstances and causes of death. At home, surrounded by family and friends in a comforting environment, patients have some control over what remains of their lives. "Home death is a powerfully significant experience," the author writes, "despite the strain, exhaustion, and conflict that sometimes accompany it. Its power lies in the fact that in the face of certain death, the caregiver can give the person life, that is, the continuation of life as a social being."