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End of Life & Palliative Care

We have made great strides in caring for those with advanced, progressive or incurable terminal illness, but there is still a way to go.

Landmark Work in the Field

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Mixed Trends in Cancer Care at Life's End

When it comes to advanced cancer, most patients would prefer care aimed at minimizing their symptoms. That's not what many of them get. Hospice care for Medicare patients with advanced cancer is on the rise, but so are the rates of end-of-life treatment in intensive care units, according to RWJF-supported research from the Dartmouth Atlas project.

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Transforming End-of-Life Care

When we first entered the field, the standard approach to the care of dying patients focused on aggressive, ineffective and often painful treatment, even as the unchangeable reality of death stared patients, loved ones and medical professionals squarely in the face. We joined and helped advance the movement that changed the way physicians deal with dying and death.

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Robert Wood Johnson Foundation Series on Health Policy

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Palliative Care: Past, Present, and Future

"Palliative care wins trust because it begins and ends with what patients and families say they want and need," says Diane E. Meier, M.D., one of the field's leaders, in this compelling essay. She examines the emergence of palliative care, and why care of the seriously ill is an important issue within the health and health care arena—and how the current health care system is unable to cope with it.

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Transferring Care from the Hospital to the Nursing Home

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Palliative Care in Long-Term Care

Transferring patients from hospital palliative care to nursing home palliative care requires careful planning and coordination between numerous parties, including family members and medical teams. In these “Notes from the Field,” academic and medical professionals discuss the transition from hospitals to nursing homes.

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Related Topics

  • Aging
  • Nursing Homes
  • Family Caregiving
  • Nursing

Report on End-of-Life Care

Trends and Variations in End-of-Life Care

Chronically ill Medicare patients spent fewer days in the hospital and received more hospice care, but at the same time there was an increase in the intensity of care for patients who were hospitalized, according to a Dartmouth Atlas Project report on trends and variation in end-of-life care.

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Quick Facts From This Report

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  • About one-fourth of all Medicare spending goes to pay for the care of patients in their last year of life.
  • Chronically ill patients were significantly more likely to be treated by 10 or more doctors in the last six months of life in 2007 than they were in 2003.
31%

The percentage of hospitals providing palliative care

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Recent Work in the Field

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Getting the Best Care for Mom and Dad

An RWJF grantee finds the key to choosing the best hospital for older adults. Alicia Arbaje, MD, MPH, has produced new evidence on how to keep older adults out of the hospital, healthy and in their own homes.

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About Advance Directives

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Five Wishes

Learn more about advance directives and how to express care preferences at the end of life. Five Wishes is an initiative of Aging With Dignity, a nonprofit that seeks to safeguard the rights of the sick, aging or dying. The Foundation supported the introduction of Five Wishes in 1997.

Visit Five Wishes

End of Life and Palliative Care

Blog Post

Scott Simon, His Mom, and Twitter: A Very Public Death

Thank you, Scott, for virtually helping so many people cope with their own grief, and for getting us to think about death, dying, and grievi...

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Book

The Development, Status, and Future of Palliative Care

From Palliative Care: Transforming the Care of Serious Illness, this essay examines the emergence of palliative care and why care of the ser...

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Journal Article

Physician Use of Advance Care Planning Discussions in a Diverse Hospitalized Population

This article presents a study of advance care planning among minority hospital patients and physicians. The authors interviewed patients to ...

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Report

Quality of End-of-Life Cancer Care for Medicare Beneficiaries

Report shows that many challenges remain to improving the care of patients with serious, life-limiting illness.

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Program Results Report

National Cancer Pain Initiative Resource Center Supports State-Level Initiatives as They Implement Pain Management Practices

Faculty and staff at the University of Wisconsin School of Medicine and Public Health established the Resource Center, to support the growth...

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Program Results Report

Care at the End of Life Still Not What It Could Be

Joan Teno of the Brown University School of Medicine, Providence, R.I., analyzed existing data, interviewed bereaved family members and cond...

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Journal Article

Discussions with Physicians about Hospice Among Patients with Metastatic Lung Cancer

Many terminally ill patients enroll in hospice only in the final days before death or not at all. Discussing hospice with a health care prov...

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Program Results Report

Project in Alaska City Struggles with Faith in Action Name

Sitka is a coastal island city accessible only by boat or air. A number of the 8,800 residents of this isolated community do not have family...

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Book

Palliative Care

Palliative Care:Transforming the Care of Serious Illness is the first book to provide a comprehensive understanding of the new field that is...

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Program Results Report

Nurse Educators Receive Training in End-of-Life Care

The American Association of Colleges of Nursing conducted 15 training conferences designed to enable nursing school faculty to integrate ins...

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Program Results Report

Online Courses for Nurse Educators and Nurses on End-of-Life Care Across the Life Span

Two schools of nursing developed electronic toolkits: one for nurse educators and one for self-study by practicing nurses.

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Issue Brief

Key Issues in Health Reform

Proposed health reform legislation aims to shake up the status quo in the delivery of health care and is raising questions about the role of...

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