Dying in institutions

Dying in institutions, such as hospitals or nursing homes, is a prevalent and often distressing reality. Here are some key insights from experts on this topic:

• Lydia Dugdale, from her appearance on the EconTalk, noted that the loneliness and isolation of dying in institutions became especially pronounced during the COVID-19 pandemic, with nursing homes being on lockdown for an extended period. She emphasized the importance of nurturing relationships before it’s too late, suggesting that living well can make dying well more achievable 1.

• Peter Attia and BJ Miller discussed the nature of deathbed regrets and the transformations in hospice care. They highlighted that chronic illnesses, which provide a protracted period for patients to reflect on their end-of-life choices, are now more common causes of death than cancer. This period can be an opportunity to find peace and address unresolved emotional matters 2.

• Michael Hebb pointed out that a significant number of people prefer to die at home, but often end up in hospital settings due to the default medical approach of prolonging life at all costs. He stressed the necessity of proactive planning and having honest conversations about end-of-life preferences to avoid dying in a manner that contradicts one's wishes 3.

  
  1
  Lonely Dying
  00:36:05
  
  2
  Insights from Deathbed Moments
  01:22:59
  
  3
  Facing End-of-Life Conversations
  00:12:09
  
  4
  End-of-Life Choices
  00:04:46

• Shoshana Ungerleider emphasized the harsh realities of being intubated and hooked to machines in intensive care units—a situation many end up in, especially during crises like COVID. She underscored the importance of patients and their families understanding their options and advocating for the kind of end-of-life care that aligns with their values 4.

These insights reveal that while dying in institutions is common, the experience can be influenced significantly by early conversations, clear planning, and emotional readiness.