More and more Americans are dying at home rather than in hospitals. According to the New England Journal of Medicine, in 2017 29.8% of deaths by natural causes occurred in hospitals while 30.7% occurred at home. The percentage of people dying in hospitals has been declining for several decades. While in 1912 two-thirds of people died at home, this evened out in the 1950s. By the 1970s, at least two-thirds of people died in hospitals. Since the 1970s, the trend has reversed. Now, more people are dying at home than in the hospital. Here’s a link to a NY Times piece on the topic.
If you wish to spend your final days at home, it’s important that you plan for that. Most importantly, you need to have a Health Care Power of Attorney that appoints someone to make decisions for you if you are unable to do so for yourself. In that Health Care Power of Attorney, be sure to appoint someone who will respect your wishes to be kept at home, rather than be moved to a hospital. Of course, there might be some difficult conversations regarding your end-of-life choices. Be sure you have those rather than avoiding them. It’s important for the person you are appointing as your agent under the Health Care Power of Attorney to understand when you want intervention in a hospital and when you would want to stay at home even if it might shorten the length of your life.
Along with your Health Care Power of Attorney, you must complete an Advance Health Care Directive, often called a Living Will. That document expresses your wishes regarding end-of-life decisions. If you don’t complete an Advance Health Care Directive and you don’t have the ability to express your desires, everything possible must be done to prolong your life, even if it wouldn’t be what you want and could be quite painful. Sometimes the Health Care Power of Attorney and the Advance Health Care Directive are called different things or even combined into one document.
If you want to stay at home and die at home, be sure to plan ahead to enable that. Aside from the financial considerations, you have to put in place the legal framework which will allow you to stay at home, as outlined above. Also, it’s critical to have the sometimes-difficult conversations with your loved ones about your end-of-life choices and your desire to stay at home. Hearing your choices from you will make it easier for your loved ones to follow your wishes. It will also increase the likelihood your loved ones will cooperate with your agent under your Health Care Power of Attorney. While they may not agree with your choices, they will know your agent is doing what you wanted them to do.
A qualified Estate Planning attorney, one who focuses their practice in Estate Planning and Elder Law, can help you put a plan in place to facilitate your wishes.
Stephen C. Hartnett, J.D., LL.M.
Director of Education
American Academy of Estate Planning Attorneys, Inc.
9444 Balboa Avenue, Suite 300
San Diego, California 92123
Phone: (858) 453-2128