This is something for everyone to think about.
It appears to be a great challenge for one to be able to
belong to the lucky 20 percent of people who die at home
surrounded by one's loved ones.

No wonder someone said sometime ago that
dying is just part of living, which, of course, is always challenging.

"....25 percent of people who die at home surrounded by one's loved ones.

Doc, when you say, "one's loved one," it means the family members. I assume.

We have a tendency of believing something that is far from the truth.
When one dies at home, he will be surrounded by "people whom he loves."
Up to this point, it may be true.
But Will he be surrounded by the "people who love him"?
There is a lot of difference between "people whom he loves" and "people who love him."

Do they (meaning family members) really "love" him at his death bed?
Or do they wish him to die as quickly as possible?
The dying person may love his family but how about the other way around?
Do family members truly love him as he is dying, especially when he is dying due to the old age,
and he is dying in a protracted slow death?

When someone dies at home, will it be the best care possible?
No way. Please don't get confused in the blind faith that family members are the best ones
to have around at the time of slow death.

I am living in a retirement village 6 months out of a year.
I see a lot of people spending their last part of the life there.

To me, the best care is given by a "hired" "non-family" personal caretaker at home.
When he dies, the caretaker loses his job,
but his family gets "either or both" the inheritance or liberation from the painful duty.
Which side is likely to wish that he stays alive and well longer?
Therefore, who will give the best care for the dying person?
(Some might say that a caretaker may unnecessarily prolong the death.)

My personal observation tells me (note: I say "personal")
that I should die at my own home under care of a non-family caretaker.

I wonder what's the conclusion by Dr. Ira Byock. He hasn't said anything within your summary.
Now, you know my own conclusion and, in my opinion, who will give the best care possible.
Fortunately, I am looking the matter through the eyes of a non-doctor.

 

You have made your point very clear.
"I should die at my own home under care of a nonfamily care taker."

It is very interesting to note that I have arrived at the same conclusion some years back and
have told my wife and three adult children as well.
I might also add that I have been advocating that for most of my elderly patients in 70's, 80's, 90's
and 100's. Right now I have dozens of patients being taken care of that way.

My typical advice to patients and children are to find care givers through church connections, friends and
by running ads in local newspapers and negotiate the hourly fee.
I often have to persuade my patients' adult children instead of their insisting on placing them in assist living places
or nursing home, which will exhaust their nest eggs in a short time.

Most intelligent elderly parents do have the attitude, "over their dead bodies before they impose on
their children." Some of my patients would call taxicab to go to ER instead of calling their children.
A couple of my patients in the last year went into cardiac arrest due to VF while on the phone with 911
and survived.

We all love our children and grandchildren but don't want to impose on them.
It is indeed ideal if we have our adult children nearby, and they make visits when they can and
supervise the care by the nonfamily caregiver.

The text above is an excerpt that appeared in this month AARP magarzine.
I have not read the book.
Dying in the hospital is not necessarily bad as pictured by this author.
All the hospitals provide a palliative and hospice care and will do so as soon as family request.
Hospitals are glad to do it to save medical cost, and politicians controlling medicare has been
encouraging the hospice care for over two decades and ever more so now.

I have helped many patients die in hospice care with IV morphine, etc.
I used to bring together the entire family, including the out of state ones, before I put patients
on IV morphine, just enough to be in shallow sleep in case any children want to talk again to the patient.
One man had to be awakened two or three times so that he can sign the wills, which he neglected.
He couldn't quite sign his name, but the lawyer said that all he had to do is "just write X."
My patient made all three sons happy during the last hour of his life by signing the will.

안녕들 하세요.

울릉도에서 보고들입니다.
오늘이 울릉도에서의 마지막날인데 시간이좀있어 PC방에서 전하는것입니다.

울릉도는 생각보다 훨씬 경관이 아름다운데 땅이 좁아서 많은 관광객을
받기에는 좀 어려운것이 흠이라면 흠이네요.

하루반 걸려 울릉도를 동서 남북으로

Thank you for the report from the remote mother land.
Have a pleasant, safe journey back home, Dr. Hwang.