“The social and economic inequities patients suffer in life often shapes their death” was a key point of a July 13-14 article in the Review section of the Wall Street Journal.

It is a key point most Americans should consider, not only when they become senior citizens but, in fact, well before.

No one is immune from the necessity of looking well beyond the present to a time when frailty and need, now often beyond comprehension, are likely to be a part of daily life and tightening their terrible grip, seemingly with every passing day.

But it was the “What’s next?” that was the central point of the article in question, and that central point was the essence of the article’s thought-provoking headline and supporting information.

The headline: “More people are dying at home. Is that a good thing?”

In the article, which was written by Dr. Sunita Puri, a palliative care physician and the author of “That Good Night: Life and Medicine in the Eleventh Hour,” Puri focuses on the conundrum many families face when dealing with the question of where to spend the final days of life — either theirs or the final days of someone close to them.

“New research classifies the rise in home deaths as progress,” the message immediately under the article’s headline begins, “but we need to look more closely at what these deaths look like.”

True, as a case Puri recalled in her article made clear.

“My patient’s daughter called me in tears three days after taking her mother home,” Puri’s recollection began. “One of her employers had refused to give her family leave and let her go. She hurt her wrist while trying to help her mother stand. She gave her mother pain medication exactly as instructed by their hospice nurse and wept with concern and confusion when her mother still screamed in agony. This wasn’t the ease and dignity she had hoped to give her mother.”

Puri, now 10 years into her physician career, says it is now clear to her that there is much more to a “good” death than where it occurs.

“Presuming a home death is a success obscures important questions about the process,” she wrote. “Did this person die comfortably? Did their caregivers have the resources and guidance they needed? Was dying at home a choice or simply the only option?”

Also, how did insurance coverage, or lack of it, impact what was done or not done?

Later in her article she provided this reasonable observation/conclusion:

“Dying at home, then, is often a result of circumstances rather than choice. As policymakers consider the best ways to support a successful death, they should listen to the stories of actual patients and caregivers. Investments in more coverage for people dying in facilities, reimbursement for in-home professional caregivers and funding for programs that support family caregivers would likely minimize both patient suffering and costly emergency-room visits. In granting more peace to the dying, these changes would also improve the well-being of survivors.”

Puri’s comments didn’t ignore the relevant message that ease and dignity “can be found even within the walls of a hospital.”

Death is a topic few healthy people prefer to think about but, for everyone, the topic is lurking in the future.

Too bad that besides being such a troubling subject, it also is so potentially complicated.