More Canadians choosing to die at home

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The number of Canadians who are opting to live out their last days at home instead of the hospital has increased over the past 15 years, according to a new study.

In 1994, about 78 percent of the nation’s deaths occurred in a hospital, but by 2004 that figure had fallen to 61 percent, the study found.

The reasons for the decline are not known, but it happened in the absence of any direct shifts in government policy, researchers report in the journal Social Science & Medicine. 

"My guess is that a lot of it has to do with the fact that death is no longer unexpected,” lead researcher Donna M. Wilson, of the University of Alberta in Edmonton, Canada, said in a news release from the university.

“A lot of people are dying at an advanced age and you begin to accept the fact that it’s going to happen and it (can be) a dignified event,” Wilson said. “If you take the person to the hospital ... care is by strangers rather than family members.”

The study found that while deaths in nursing homes increased—from 3 percent of the total in 1994, to 10 percent in 2004—many more occurred in “non-institutional” settings, including people’s own homes. In 2004, 30 percent of deaths happened in a non-institutional setting, up from less than 20 percent in 1994.

According to Wilson, the trend is a positive one not only because it may mean more people are choosing to die in the place where they are most comfortable, but also because it could free up more hospital beds for people who need life-saving treatments.

It also means that the Canadian health care system should do more to support people who opt to die at home, the researcher said.

Compared with countries such as the UK and U.S., Wilson’s team notes, Canada has few hospice clinics and fewer home-care services aimed at making people comfortable in their last days.

“We need to start putting more money into home care and develop some hospices, have some courses for families and maybe build a few more nursing home beds,” Wilson said.

She pointed out that as the Baby Boom generation ages, the number of Canadians dying each year could double over the next 10 to 20 years.

SOURCE: Social Science & Medicine, May 2009.

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