Paper short abstract:

Most people in Italy die in a hospital, and yet “home” is the first choice for the dying. The paper addresses the question: why is home the best place to die? and explores home as the space of intimate relations and of familiar obligations, and tensions concerning end-of-life decisions.

Paper long abstract:

Despite statistical evidence that most of the people (around 65%) in Italy die in a hospital or in another medical setting – a common trend for the European countries – several studies show that “dying at home” still figures as the first choice for terminally ill patients. Why is home the best place to die, although being cared for in the domestic setting has become increasingly difficult following the social transformations of the last decades?

Based on a two years research on terminal illness and palliative care in Piedmont (Northwest Italy), the paper starts from the above question and explores the moral dimensions of “home” as the space of intimate relations and of familiar obligations. The house is the space where the person realised autonomy towards society, developing at the same time reciprocity towards other members of the family. This in part explains why informal caregivers often feel guilty when they decide to move the dying person to the hospital or to the hospice.

In the second half, the paper focuses on family tensions concerning end-of-life decisions, on the contrasts between the will of the patient and the ability/possibility of the family to take care of him/her and on the restructuring of familiar networks in these situations. These topics will be explored in relation to the specific context of the Italian familiar system, characterized by the presence of strong ties and of a relevant role of kins in the caregiving of terminally ill people.