Dying at home and proper end of life planning

Written by Beverley Hadgraft for Australian Seniors.                           

If you were to ask someone how they would like to pass away, most would say in the comfort of their own bed and surrounded by their loved ones. According to ABS data, most (50.1%) deaths in Australia in 2019 happened in a hospital or medical service area, 29.5% occurred in aged care facilities and only 14.8% of people died at home.

So, the question may be, what is the problem? Remember, death is a natural part of life. Have you made a plan?                                                   

According to Denise Love, it comes down to a lack of proper planning. Denise was one of Australia’s first palliative care nurses before opting for a more personalised approach and becoming a death doula, otherwise known as an end-of-life consultant.                                                       

Louise is an international trainer of death doulas and in the process of opening her own ‘Carebnd’ in Victoria. Her goal in opening this facility is to provide a space where families can come together at the end-of-life phase as an alternative to hospice or hospital. Consider whether you should write your own eulogy as well.

Planning for home deaths                                                       

Denise often helps families plan home deaths and says it’s useful to have a palliative care expert available. “We need an expert to ask the hard questions: who can commit to being there and how are we going to manage this?”                                                       

“I find most elderly people, when they’re ready to go, will stop eating and drinking and slip away in around four days. However, it might take four weeks or four months. There may be blood or bowel problems or challenging behaviours. I find people die as they lived; they won’t become peaceful and easy going just because they’re dying”.                                                           

“It’s not all blissful music and lavender oils. It can be traumatic and exhausting and if the family isn’t prepared and doesn’t have support, 90% end up putting their loved one into hospital for the final 48 hours, which can add to their grief and make them feel like failures.”

Denise says there is plenty of support available, in various forms, and can be for a few hours or round-the-clock. A local nursing agency can provide registered nurses and carers and work closely with palliative care services, managing medication and organising any specialist equipment needed.                                                        

Good doulas, especially those with a nursing background, can also be a one-stop shop for all services, and may be especially useful for people without support, since they’ll offer the kind of personalised care a family member might provide.

Should you talk to your GP about your death plans? 

A GP will also be able to advise on palliative care services, many of which are free or subsidised by Medicare. Denise points out that a home death can come with additional challenges, including the family having to make arrangements for the body.                                                                    

The simplest option is to call a funeral home, which will look after everything, she says, although she’s had situations where she’s put the deceased on a cold plate for three days and had the funeral at home with the family holding vigil. She has wrapped the deceased in a sheet, asked everyone to write messages of love over it and then organised a direct cremation.                                                                       

“Everything is possible in Australia,” Denise says. “You just need to know how to talk about it.”