The attitudes and experiences of families with death determination in the home.

The purpose of this study is to describe the attitudes and experiences of family members with respect to death determination practices for the terminally ill clients of home care agencies. A sample of family 53 members in Southeast Michigan returned survey questionnaires. The findings indicate that police and emergency medical technicians most frequently respond to the call when a person with a terminal illness has died. Fifty percent of the family members reported feeling sad, 35 percent reported feeling relieved and 18 percent of the respondents felt angry about the arrival of municipal personnel. Feelings of anger were significantly associated with the absence of a nurse at the time of death, the use of lights and sirens, disrespectful personnel and the arrival of multiple personnel. Feelings of anger were also significantly associated with continuing thoughts of the day of death by family members. Results suggest the need to rethink state and local laws in regard to death determination and to educate those most likely to respond to families sensitively. Home care agencies and hospices should also encourage attendance by nurses at the time of death.