I did a research study a couple decades ago, with frail elderly homebound individuals-about 3/4 definitely stated they wanted to die at home and didn’t want to go to the hospital for a bunch of interventions. At the time, among those folks, only about a third of those expressing a desire to die at home had documented advance directives, so it took all of about 10 minutes to have that conversation, offer to help them fill out an AD if they wanted one, and get it filled out, signed, and witnessed. After 6-12 months we did a follow up on anyone who had died to asses their place of death. 90% of deaths among those with an AD died at home (n=18) while 100% of those without an AD (n=2) died in the hospital. We didn’t do a cost analysis, but prior to our convo to ask if they wanted help to fill one out, had the same people died, it would likely have been n=6 dying at home and n=14 dying in the hospital. DEFINITELY a higher price tag, and not even what most of them wanted!

Grandma should NEVER feel OBLIGATED to die, but when you talk to seniors they are usually pretty clear and what they want and what they don’t want-and I think we should listen to them!