Care in the home

  • Lucinda Langford

Abstract

Many patients with a terminal illness express a desire to die at home (Townsend et al., 1990). Here they can remain within the security of a known environment, surrounded by family and friends and be cared for by the family general practitioner. At home there is more opportunity for the patient to have greater control over decision making and life is not being dictated by the endless routines found in busy hospital wards. Household noises are familiar and less likely to disturb sleep, unlike those made by the clanking of bedpans, drug rounds or the confused patient in the bed next door. Families are not restricted to visiting hours and the patient’s diet will often be more accommodating to their particular needs and fancies on each day. Familiarity is comforting and contributes towards a feeling of safety and belonging. However, perhaps most importantly, dying at home enables the individual to continue to be seen as a person and not just as another patient in another hospital bed.

Keywords

Catheter Syringe Expense Burial Dial 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Baddeley, P.G. (1991) A place to die: home, hospice or hospital? Geriatric Medicine, 21 (5), 14.Google Scholar
  2. Bond, M. (1986) Stress and Self-Awareness: A Guide for Nurses, Butterworth Heinemann, London, pp. 10–13.Google Scholar
  3. Field, D. and James, N. (1993) Where and how people die, in The Future for Pal- liative Care, (ed. D. Clark ), Open University Press, Buckingham, pp. 6–29.Google Scholar
  4. Maslow, A.H. (1943) A theory of human motivation. Psychological Review, 50, 370–96.CrossRefGoogle Scholar
  5. Pardoe, J. (1991) How Many Times Can You Say Goodbye? Triangle/SPCK, London, p. 93.Google Scholar
  6. Parkes, C.M. (1978) Bereavement — Studies of Grief in Adult Life, Penguin, Harmondsworth.Google Scholar
  7. Sherr, L. (ed.) (1989) Death, Dying and Bereavement, Blackwell Scientific Publications, Oxford, p. 48.Google Scholar
  8. Townsend, J., Frank, A.O., Fermont, D. et al. (1990) Terminal cancer care and patients’ preference for place of death: a prospective study. British Medical Journal, 301, 415–17.CrossRefGoogle Scholar
  9. Twycross, R.G. and Lack, S.A. (1990) Therapeutics in Terminal Cancer, 2nd edn, Churchill Livingstone, Edinburgh, p. 47.Google Scholar
  10. United Kingdom Central Council for Nursing, Health Visiting and Midwifery (1992) Standards for the Administration of Medicines, UKCC, London.Google Scholar

Further Reading

  1. Aggleton, P. and Chalmers, H. (1990) Nursing Models and the Nursing Process, Macmillan Education, Basingstoke.Google Scholar
  2. Burns, N., Carney, K. and Brobst, B. (1989) Hospice: a design for home care for the terminally ill. Holistic Nursing Practice, 3 (2), 65–76.Google Scholar
  3. Copperman, H. (1983) Dying at Home, John Wiley and Sons, Chichester. Department of Social Security (1990) What to Do After a Death, Leaflet D49, HMSO, London.Google Scholar
  4. Dobson, S.M. (1991) Transcultural Nursing, Scutari Press, London.Google Scholar
  5. Doyle, D. (1987) Domiciliary Terminal Care, Churchill Livingstone, Edinburgh. Dunlop, R.J. and Hockley, J.M. (1990) Terminal Care Support Teams, Oxford University Press, New York.Google Scholar
  6. Dunlop, R.J., Davies, R.J. and Hockley, J.M. (1989) Preferred versus actual place of death: a hospital palliative care support team experience. Palliative Medicine, 3, 197–201.CrossRefGoogle Scholar
  7. Dunphy, K.P. and Amesbury, B.D.W. (1990) A comparison of hospice and home care patients: patterns of referral, patient characteristics and predictors of place of death. Palliative Medicine, 4, 105–11.CrossRefGoogle Scholar
  8. Hector, W. and Whitfield, S. (1982) Nursing Care for the Dying Patient and Family, Heinemann Medical, London.Google Scholar
  9. Jay, P. (1990) Relatives caring for the terminally ill. Nursing Standard, 5, 30–2.Google Scholar
  10. Jones, R. (1992) Primary health care: what should we do for people dying at home with cancer? European Journal of Cancer Care, 1 (4), 9–11.CrossRefGoogle Scholar
  11. Logan, M. (1988) Care of the terminally ill, includes the family (using the Ray model). Infirmiere Canadienne, 84(5), 30–2, 34.Google Scholar
  12. Mudditt, H. (1987) Home truths (families looking after a terminally ill patient at home need help and advice). Nursing Times and Nursing Mirror, 83, 31–3.Google Scholar
  13. National Health Service and Community Care Act (1990), HMSO, London..Google Scholar
  14. Richardson, J. (1993) A Death in the Family, Lion Publishing, Oxford.Google Scholar
  15. Saunders, C. and Sykes, N. (1993) The Management of Terminal Malignant Disease, Edward Arnold, London.Google Scholar
  16. Thorpe, G. (1993) Enabling more dying people to remain at home. British Medical Journal, 307, 915–18.CrossRefGoogle Scholar
  17. Woodhall, C. (1986) A family concern (is it better to die at home or in hospital?). Nursing Times and Nursing Mirror, 82, 31–3.Google Scholar

Copyright information

© Springer Science+Business Media Dordrecht 1995

Authors and Affiliations

  • Lucinda Langford

There are no affiliations available

Personalised recommendations