Home, Please

Home, please . . .

Home, please . . .Where do you want to die?

Where do you want to die?

This is not a popular question. In a conversation that matters with people who matter in your life, it’s tough to ask, maybe tougher to answer.

There are an assortment of questions that are easily answered or cleverly avoided: do you have a crush on that girl/boy, what’s your major, did you serve in the military, what’s your favorite team, are you two getting married, what do you do for a living, what will you name your child, what’s for dinner, and should we buy a house or keep renting? Questions are age-related or relationship-based or inspired by situations. We all ask them, since they help us get to know another person. When we ask them, we may also be wondering about our own responses. At the least, these queries—and so many others—help keep an encounter lively and ongoing and . . .

However, the “Where do you want to die?” question is likely a conversation killer. Who wants to make the time for that question? It’s morbid. It’s personal. It’s upsetting.

Is it easier to answer the question’s flip side? Where don’t you want to die?

Please, not a hospital. Even more, not in a sterile room in intensive care, with machines humming and tubes running in and out and of my body.

Please, not in a nursing home. Not in a place where I’d have to share a room with one or two or more persons. Not in a place where I have to conform to their schedule and can never do anything on my own. Where the smells are bad and the lights are on and the noise never stops.

I just want to be at home. True?

But before exploring what that answer means, are there other places where you don’t want to die? And, if so, why? Here, I’m tempted to list a few more don’t-want-to-be-there examples, but it’s more important that you ponder your singularly unique response.

How many would say they want to die at home? I’ll guess . . . almost everyone. My parents did. For years, Mom and Dad would express some variation of, “Just keep me home and take me out of here feet first when I die.” It was a joke, and it was serious, and usually the conversation would soon veer onto safer subjects. However, both of them died away from home. Sometimes, there aren’t choices.

In some of my past work at hospice, I’ve been responsible for explaining Medicare benefits to potential patients. Many of my visits were in hospital rooms. With only a spouse nearby—or perhaps also with children, parents, or grandchildren crowding the room—I’d provide the basics about what hospice could or could not do. Some patients, hugging their hospital gowns close to their chests, asked lots of questions. Others, drowsy in bed, barely seemed to listen. But I don’t recall anyone saying they hoped to stay in the hospital longer . . . instead, it was always, I just want to go home.

I think there is another question that could be asked before the “where” question. (And I’m not the first to ask it*.) But this question is one that should be more important than the “what is your major” or “is it time to buy a house” or all the other safer questions in the various stages of our lives. Here ‘tis: How do you want to live? Which is to say, what are your values? Who are the most important people to you? What do you truly like to do with your time?

Don’t fantasize with the question (and its companion questions). Don’t imagine you’ll win the lottery and get rich. Don’t imagine you’ll be the next Bill Gates with whiz-bang ideas and unlimited cash. Wealthy or poor, young or old, all can equally, honestly ponder: how do I want to live?

If the hard question (where do you want to die) with the easy answer (home) is posed with the how do you want to live question, I believe your unique answers will help you make better decisions for every part of your life, from birth to death.

 

*A recent book I’ve read that struggles with these questions is surgeon Atul Gawande’s “Being Mortal.” Read it and you’ll see I’ve been influenced by Gawande’s concerns. Read it, and I think you’ll ask better questions of yourself, your loved ones, and your doctors. In one of the many powerful recollections in the book, Gawande asked a terminally patient if he wanted a high-risk surgery (with more time in the ICU and uncertain recovery). The patient’s unexpected answer: I’d like to be home, watching football, eating chocolate ice cream . . .

(Hospice vigorously protects a patient’s privacy. I’ll take care with how I share my experiences. Any names used are fictitious. Events are combined and/or summarized.)

Image from here.

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