Although considerable effort is being directed at providing patients and their families with a “good death,” most patients in intensive care units, if given the choice, would prefer to die at home. With little guidance from the literature, the palliative care committee of an intensive care unit developed guidelines to get patients home from the intensive care unit to die. In the past few years, the unit has transferred many patients home with hospice care, much to the delight of their families. Although several obstacles to achieving this goal exist, the unit has achieved success in a small-scale implementation of its Going Home Initiative.

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Some simple nursing interventions can have extraordinarily therapeutic results for patients and families. A man was transferred to our intensive care unit after suffering a devastating head injury. Knowing he would not survive, I felt that his wife needed the opportunity to lie beside him one more time. Her response prompted me to write this in hopes of enlightening other nurses who may, for whatever reason, be reticent to try this approach to healing.

Sometimes, families and patients compel intensive care unit clinicians to continue aggressive therapies even when the odds of patient recovery are grim. This experienced critical-care nurse suggests that such scenarios are more likely when clinicians use imprecise or ambiguous language when discussing patient prognoses.

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