Supporting patient wishes for death at home

Wherever we call home, most of us long to be there.  No matter the condition of the floors, or the quality of the curtains–perhaps no curtains, that is the place we want to be at the end of the day. But what about at the end of our lives?

Home may look different from the traditional images in our mind’s eye.  In the 90s I had a hospice patient whose address changed every fortnight.  She would call me and give me her new location.  The law in Los Angeles was that you could not park a vehicle for more than 14 days before having to move.  She lived in a small RV-like vehicle.  She was officially considered homeless, but this is not the way she saw it. This was her home; this is where she wanted to be, and in the end, this is where she longed to be, as she died in the hospital.

I have cared for people in strange non-traditional homes.  I have been to many a “flop-house”, I have changed wound dressings in the men’s room at a Salvation Army (the men were not allowed back to the sleeping area during the day), and I have stepped over glue traps at the front door of a house with a mouse wriggling to save its own life as I cared for the dying occupant inside. These people were where they wanted to be and were dying the way they had lived.

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