Choosing where to die

Your loved one might have choices for end-of-life care. Options might include:

• Home care. Most people prefer to die at home or in the home of a family member. You can assume the role of caregiver or hire home care services for support. Hospice care — services that help ensure the highest quality of life for whatever time remains — can be provided at home as well.
• Inpatient care. Some people might prefer round-the-clock care at a nursing home, hospital or dedicated inpatient hospice facility. Hospice and palliative care — a holistic treatment approach intended to ease symptoms, relieve pain, and address spiritual and psychological concerns — can be provided in any of these environments.

Seek clarity about the type of care your loved one wants at the end of life. Many people approaching death choose to stop treatments that cause significant side effects, preferring treatments that improve comfort. Your loved one also may prefer to die free from the burdens of life-support machines such as ventilators and dialysis machines.

You may worry that stopping these types of treatments will hasten your loved one's death, but studies show that focusing on symptom control does not generally shorten life, and may even extend it, while helping your loved one experience a peaceful death.

When you discuss the options with your loved one, consider his or her preferences as well as special physical, emotional and psychosocial needs. Evaluate how much support can be provided by family members and friends. For help determining the best option, talk with your loved one's health care team or a social worker. You might ask for a referral to palliative or hospice care specialists — health care providers trained in specific care for people nearing the end of life.