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Business of Health Care: Dying at Home

Michael Hagerty

For the first time in over a half century, more people in the United States are dying at home than in hospitals – a remarkable turnabout in Americans’ view of a so-called “good death.”

In 2017, 29.8 percent of deaths by natural causes occurred in hospitals, and 30.7 percent at home, according to research in the New England Journal of Medicine.

The gap may be small, but it has been narrowing for years, and researchers believe dying at home will continue to become more common.

Studies show that about 80 percent of Americans prefer to die at home – not in an institutional setting.

Many are horrified by the prospect of expiring under fluorescent lights – hooked to ventilators, feeding tubes, and other devices that only prolong the inevitable.

Advocacy groups have encouraged families to have difficult conversations about end-of-life care, which often reveal that older relatives do not want heroic measures to extend their lives in hospitals.

About 45 percent of older adults have completed advance directives, which often specify that doctors should not take extreme measures to prolong life.

And hospice care, usually delivered at home, is more available than ever before. Hospice provides pain management, along with emotional support and care, to terminally ill patients nearing the end of their lives.

If dying at home is a priority to you, make sure you express those wishes to your healthcare providers and your family.

Better yet, spell out those desires in an advance directive. Doing so can make the end a lot easier on both you and your loved ones. 

This report, and other episodes, are available at Business of Health Care is a production of KWBU and Baylor Scott & White Health. 

Glenn Robinson has been the President of Baylor Scott & White Medical Center – Hillcrest since September 2007. He previously held several CEO positions at hospitals in Texas, Oregon, and South Carolina. A Georgia native and graduate of the University of Alabama, Glenn completed graduate school at Trinity University in San Antonio, Texas.