[ Health Report ] More Americans Dying at Home than in Hospitals (2019-12-23)

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For the first time since the early 1900s, more Americans are dying at home than in hospitals in the United States. A new report says this shows that more people are receiving the kind of end to their lives that most Americans say they want. The report notes that deaths in nursing homes also have decreased.

The findings were published earlier this month in The New England Journal of Medicine.

Haider Warraich is a doctor with the Veterans Affairs Boston Healthcare System. He was the lead writer of the report. Warraich said the fact that more Americans dying at home is "a good thing. Death has become overly medicalized over the last century" and this shows a turn away from that, he said.

Betsy McNair is a tour guide who now lives in Mexico. She told The Associated Press she is pleased with the ending she helped give her father, Robert McNair. He died at home in Belle Haven, Virginia in 2009, just six weeks after learning he had lung cancer. He was 83 years old.

Betsy McNair remembers, "I made him exactly what he wanted to eat, whenever he wanted it. He had a scotch every night, he had a very high quality of life. If he woke up at 2 o'clock in the morning and wanted to have coffee and pie, that's what we did."
Warraich and Duke University graduate student Sarah Cross used U.S. government health information on deaths from natural causes. They studied records for the period from 2003 through 2017. They found that deaths in hospitals fell from 40% to 30% over that period and in nursing homes from 24% to 21%.

Deaths in homes rose from 24% to 31%. Researchers said they had no way to tell if some assisted living centers may have been counted as homes.

Cancer patients were more likely to die at home than in a hospital. People suffering from memory loss, lung diseases or who lived in a nursing home were more likely to die in a hospital.

Betsy McNair noted that the kind of disease matters. She helped care for a brother who had amyotrophic lateral sclerosis (ALS) in his 50s. ALS causes the death of neurons controlling voluntary muscles in the body. She also helped care for her mother, who died at age 92 in a nursing home after her health worsened.

McNair said "they were all completely different experiences." She added that sometimes it is not possible to effectively care for a family member at home.

Warraich said the rise of home hospice services has helped more people spend their last days at home. Hospice care is set up to help those who are very sick.

Warraich said, "I have met many patients who just want to spend one day at home, around their dog, in their bed, able to eat home food."

He added, "Ideally we'd like to see people live longer and with fewer disabilities. We have work to do there."

I'm Jonathan Evans.

Marilynn Marchinone reported this story for the Associated Press. Jonathan Evans adapted her story for VOA Learning English. George Grow was the editor.