What is a good death?
This is a very important question that needs to be individually answered by everyone.
What situation would you describe to be a good death for you? What situation is NOT a good death?
Choice and preference vary for each person. Some people may want to be at home on hospice care with their loved ones caring for them. Others absolutely hate the idea of their children or loved ones bathing them or cleaning them. It’s important to let others know what you want so you can be comfortable and, so they don’t have make the choice for you. God forbid they chose something for you that you don’t want and you aren’t able to ask for what your need.
Things to consider when thinking about your ideal death situation:
- Where do you want to be when you die? Would you prefer to be at home or in a hospital/skilled nursing setting?
- Who do you want to be there with you when you pass? Who do you NOT want to be with you?
- What sensory experiences do you want? Do you want a quiet, dimly lit room with essential oils and soothing music? Or do you want your entire loud boisterous family there cracking jokes, playing with children and spending time with you?
- How do you want your body cared for after you pass?: Do you want religious rites given? Would you like to be embalmed? Do you want your body donated to science? What about your internment? How much do you want your family to spend on a casket, burial vault or liner? Do you care if insects can assist in the decomposition of your body or do you want to be buried in a hermetically sealed tomb?
- Are there any tasks or experiences you want to be completed prior to your passing? If possible, is there a trip you want to go on prior to passing? Is there a project or legal matter that needs to be completed in order for you to feel at peace? Do you need to make amends with someone?
The Five Wishes
The Five Wishes document is an advanced directive document that allows a person to make their end of life wishes known. In some states, if notarized it is a legal advanced directive.
Hospice and Palliative Care
In the right situation, home hospice can be a beautiful and meaning-filled experience for the dying and their families. There are also some complications to keep in mind in order to decide if home hospice is right for you.
Do you have loved ones who can physically and emotionally provide 24/7 care for you? While home hospice and home care agencies provide CNA’s and RN’s to assist with care they are generally not present for more than an hour at a time each day. Some agencies do not provide bathing care 7 days a week. Be sure to ask your agency what they provide and how often you can rely on those services. Is your family able and willing to assist with personal care and cleaning when you are unable to toilet yourself? Are you willing to allow your family to do these things for you? If not, can your family afford to private pay for a CNA to assist in your care?
Is your family okay with having you pass away in the family home? This is a very individual consideration. Some families find comfort in knowing that their home was the last place their loved one was alive. Other families are horrified by the thought of someone passing in their home and may feel haunted by the memory of you dying where they live. This is an important consideration for your family if they will continue to reside in the home where you pass.
Can your family afford to take leave from work to provide 24/7 care? Financial considerations can seem cold at end of life and they are not without consequences. Depending on your family financial situation, savings and paid leave accruement: Can your family still pay their bills after you pass if they leave work to take care of you at home?
How close is your family, and are there any long standing emotional rifts or conflicts? The sad fact of life is that not everyone has an ideal family story. There may be a history of estrangement, substance abuse, emotional or physical abuse and/or conflict in the family that makes home hospice care untenable for everyone involved. While it may be the “ideal situation” to be able to care for your loved one at home, past or present conflict may create a more painful situation than is necessary. It is important to weigh the positives and negatives of home hospice versus hospice provided in a skilled nursing facility if there is a history of significant family discord.