Planning for a Home Death
There are a number of things that will need to be considered when planning for a home death:
- The specific needs of the dying person and their family.
- Management of symptoms and care needs.
- A way to record evidence of care as it is delivered.
- Identification of cultural preferences.
- Identification of advance care plans and or advance care directives.
- Need for additional supports such as care workers, volunteers or specialist providers.
- Identification of any equipment required.
- Provision of contact details of appropriate services that will be needed in the event of change or crisis.
- Provision of information about signs that death may be occurring.
- Guidance for what to do following the death.
- Provision of funeral service contact details.
More information can be found on the CareSearch website -
Planning for a Home Death.
Managing symptoms in the community presents many unique challenges to health care professionals.
Barriers that may be encountered include the environment, limited access to other health care professionals, equipment and medications.
Community service provision needs to be flexible to meet the older person and their family’s needs.
The GP should be advised that the patient’s condition has changed and that symptoms of the terminal phase are now present.
This is a chance to review any terminal care requirements.
Family carers often immerse themselves in their role and may be loath to consider their own needs at this time.
They may struggle with the increasing demands of caring in the last days of life.
Feelings of ambivalence, anxiety or anger are common, particularly for those who find themselves isolated and unsupported.
Caring has social, economic, emotional and physical costs and the nurse may recognise family care strain in the following manifestations:
- Sleep disorders
- Fatigue
- Headaches
- Feelings of uncertainty, hopelessness and helplessness
The community nurse who uses the palliative approach can teach carers how to care for a dying person, how to care for themselves, how to make meaning of the situation and help carers to address other issues that may arise, such as differing family engagements in the process.
Helping carers learn to manage new or challenging tasks and supporting them in their carer role can have a positive effect on carer well-being.
Where an ACP or ACD has been completed, it is important to ensure this information transfers with the patient to the hospital. In addition, the SDM should hold a copy of the ACD in order to be able to provide it if required.
In considering a transfer to hospital, it is important to attend to the resident’s stated preferences and wishes. Specific refusals of medical treatments and interventions should be respected if intended to apply to the current circumstances. The benefits and burdens of any transfer should be weighed.
Families need to be aware of what to do after the death. Providing them with information at the start of the terminal care period about the dying process and what needs to be done after death is important.
Make sure they know a death certificate is required. Check they have the appropriate phone numbers.
After the death, it is important that the service provider address any estate issues or financial matters.
Page updated 17 April 2018