There's no place like home.
Ihave always been passionate about caring for patients at home. Among all medical disciplines, it is almost exclusively family doctors who offer housecalls. It is our territory. It is our history. It helps define us. We are the physicians who care for people across all geographic settings—not just in the office or hospital. It is the intimacy of treating patients and their families in the home environment that symbolizes for me the closeness of the personal relationship that exists between us and our patients. Caring for people at home is a core professional task of family physicians. 1 The cost and health benefits of keeping patients in their homes have been well documented. 2 The personal rewards help some physicians reconnect to the reasons they studied medicine in the first place. The appreciation of patients and their families for this care is usually beyond words. Much of my clinical practice involves caring for patients near the end of life in their homes. I love what I do and it is a privilege to be able to provide this kind of care. I recently reflected back to my residency, during which I undertook a study of “home birthing.” I concluded that it wasn’t a safe practice in Canada, but on a deeper level, it made intuitive sense to me. And now I’m helping people with “home dying.” Most Canadians would choose to be at home at the end of life, 3 but very few get the chance. And only about 10% to 18% of Canadians older than 65 years, depending on the province in which they live, receive any home care during their later years. 4