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Do the dying live longer at home or in hospitals?
More Americans would rather die at home than in hospitals, and there's new research that suggests the dying are not only more comfortable, but live longer if they remain at home. - photo by Jennifer Graham
Most Americans would rather die at home than in a hospital, and new research suggests that the terminally ill are not only more comfortable in familiar surroundings but also live longer.

A study published March 28 in Cancer, the journal of the American Cancer Society, found that Japanese patients dying of cancer at home lived nearly a week longer than those receiving care in a hospital.

The results should reassure families that home care is not only a viable choice, but may even give their loved ones a few extra days, the researchers said.

The cancer patient and family tend to be concerned that the quality of medical treatment provided at home will be inferior to that given in a hospital and that survival might be shortened," said Dr. Jun Hamano, one of the authors.

"However, our finding that home death does not actually have a negative influence on the survival of cancer patients at all, and rather may have a positive influence could suggest that the patient and family can choose the place of death in terms of their preference and values," Hamano said.

Hamano and his colleagues studied the final days of 2,069 patients between 2012 and 2014, wrote Leah Lawrence on The patients were divided into three groups: those given days, weeks or months to live.

While there was no significant difference in survival times among those given months to live, hospital patients expected to die within days survived an average of nine days, compared to 13 days for those who died at home.

For patients given weeks to live, those in the hospital lived an average of 29 days, compared to 36 days at home, Lawrence wrote.

In their report, the researchers said their findings suggest that oncologists "should not hesitate to refer patients for home-based palliative care simply because less medical treatment may be provided."

Writing in STAT, Jennifer Adaeze Anyaegbunam said, There is a delicate tipping point where life-prolonging treatments become counterproductive, ineffective, burdensome, and may even hasten death.

But the STAT report notes that home care can be expensive and quotes Dr. Cardinale Smith, an oncologist at Mount Sinai Hospital in New York City, as saying it will provide "fuel to the fire for policy makers so that we can provide this care to all of those who need it."

According to the Stanford University School of Medicine, 80 percent of Americans say they would prefer to die at home, but just 20 percent of us do. Sixty percent die in hospitals, and 20 percent in nursing homes.

For people trying to decide what is the better option for themselves or a dying loved one, the U.S. government's National Institute on Aging offers an online comparison of hospital, nursing home and palliative home care.
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