Health caregivers working with palliative patients in the home are able to establish closer relationships with these patients than in the palliative hospital setting. Since a familiar and comfortable setting helps set the stage for effective communication, it is not surprising that home care patients and their families often share intimate thoughts and feelings with visiting caregivers. Yet that same closeness can make it more difficult for a home caregiver to accept a patient's denial of impending death. While agreeing that, in theory, denial is a normal defence mechanism, the home caregiver may have become too emotionally involved to appreciate denial as a particular patient's choice.
