Coping with mortality is never easy, but patients and families may experience less difficulty in certain geographic areas. There are signs that Vermont and Utah are states where people were more likely to have a better end-of-life experience, while families in New Jersey or New York might struggle more.
A recent analysis by insurance company PolicyGenius ranked the factors associated with the death of a loved one in each state and the District of Columbia. The organization based its findings on indicators such as the number of people who died at home, the availability of palliative care, access to green burials and funeral costs.
The analysis also considered the ratio of Medicare-certified healthcare providers to eligible patients, as well as approval processes.
The report concluded that Vermont was “the best place to die” in the United States.
“[Vermont] ranked fifth for density of funeral homes and related services, including cemeteries and crematoriums, and third for green burial options,” the report states. “However, the average funeral costs are more expensive than 86 percent of the country, which makes sense given Vermont’s above-average cost of living.”
PolicyGenius also cited the availability of palliative care in the state, though throughout its national comparison it focused on hospital settings rather than community services. About 38% of Vermont decedents died at home rather than in a facility, according to the report.
Utah ranked second according to the analysis. At 42%, the state had the highest proportion of decedents who reached end of life in their residences. Utah fell short of the top spot due to its low concentration of funeral homes.
Incidentally, in 2018, Utah also had the highest hospice utilization rate among Medicare decedents at 60.5%, compared to the national average of 50.3% that year. according to the National Hospice & Palliative Care Organization (NHPCO).
Other states in PolicyGenius’ top 10 include Idaho, Ohio, South Dakota, Maine, New Hampshire, and Washington, with Illinois and Colorado tied for seventh.
The analysis cited data for each metric ranging from 2018 to early 2022, depending on the individual indicator. For deaths at home, for example, the report included figures from 2018 to 2021. While probate data was based on information from early 2022.
For the lowest-ranked states — New York and New Jersey — the deciding factors were high funeral costs and lower percentages of deaths at home, 29.7% and 29.9%, respectively.
The analysis noted that New Jersey has made progress in recent years in terms of making hospice care more available.
“On the bright side, New Jersey excels in palliative care, ranking 9th for this data point,” PolicyGenius said. “In 2019, the state enacted a palliative care law, aimed at identifying patients who could benefit from these services and making the information more readily available.”
Other states the report calls “the worst places to die” include Hawaii, Texas, Alaska and Florida.
Nationally, the burden on bereaved families is heavy, other research shows.
Families spend up to 500 hours over 13 months performing administrative tasks related to the death of their loved one, according to a recent report by bereavement technology company Empathy.
The average cost for bereaved people exceeds $12,000, according to this report. These factors also cause stress that can complicate bereavement and adversely affect the health and work performance of family members.
“Grief is made harder by logistics and logistics is made harder by grief,” Ron Gura, co-founder and CEO of bereavement care technology platform Empathy, told Hospice News. “If you have to get up in the morning and call Amazon to remove your partner’s name, call [U.S. Department of Veterans Affairs]having a ceremony, working with social security, IRAs, pensions, real estate brokers, probate court, it just makes it worse.