Hospice at Home, Or in the Hospital - Where Would You Choose to Die?

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A noisy, chaotic, and bureaucratic hospital enduring tests and procedures? Or a calm, relaxed, and personal home, pain free and comfortable? Which would you choose for your final days and hours?

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My dad spent his last few months of life in and out of hospitals, SNFs, ambulances and doctors' offices while getting ineffective weekly chemo, tests, and procedures.

My mom spent her last few months of life at her assisted living facility in hospice care, with her sons around, hospice nurses taking great care of her, pain free, and her gerontologist watching her in her home.

My dad died in the hospital, an 87 year old man with severe bone cancer, prostate cancer and kidney failure. At the very end, the doctor wanted to put him on dialysis. We asked why, and the doctor said (basically) "because we can". When asked if dad was a good candidate for treatment, the answer was "not really". Noisy and chaotic, the hospital was impersonal, cold, and bureaucratic. The care was professional and good, but very expensive and relatively useless. Dad finally had a stroke and died as we brothers and mom watched.

My mom died at home, an 84 year old woman with dementia and pneumonia. At the end, her gerontologist tried some IV antibiotics for a couple of days, but deferred to her DNR and advance directives and stopped them when it became obvious they were useless. She was in her home - calm, relaxed, pain free and comfortable when she died.

Could my dad have stopped his chemo, his treatments and procedures, and lived out his days in hospice care? Yes. Did he choose to do that? No. Could my mom have chosen to forgo hospice and go the hospital and SNF route? Not really as her dementia was too debilitating. Did my brothers and I decide hospice was the right choice? Yes.

I am not trying to indict hospitals. I am not trying to make decisions for anyone. I AM asking caregivers and trustees to consider the option of hospice when caring for elderly parents and making medical treatment decisions. In our case, hospice was the right choice for our mom.

There is no one size fits all answer. The circumstances of any particular situation should always dictate the best choice of treatment. However, after living through both scenarios I would tell everyone to consider hospice as your aging parent's final treatment plan.

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