For patients and their loved ones, no care decisions are more profound than those made near the end of life. Unfortunately, the experience of dying in the United States is often characterized by fragmented care, inadequate treatment of distressing symptoms, frequent transitions among care settings, and enormous care responsibilities for families. According to this report, the current health care system of rendering more intensive services than are necessary and desired by patients, and the lack of coordination among programs increases risks to patients and creates avoidable burdens on them and their families. Dying in America is a study of the current state of health care for persons of all ages who are nearing the end of life. Death is not a strictly medical event. Ideally, health care for those nearing the end of life harmonizes with social, psychological, and spiritual support. All people with advanced illnesses who may be approaching the end of life are entitled to access to high-quality, compassionate, evidence-based care, consistent with their wishes. Dying in America evaluates strategies to integrate care into a person- and family-centered, team-based framework, and makes recommendations to create a system that coordinates care and supports and respects the choices of patients and their families. The findings and recommendations of this report will address the needs of patients and their families and assist policy makers, clinicians and their educational and credentialing bodies, leaders of health care delivery and financing organizations, researchers, public and private funders, religious and community leaders, advocates of better care, journalists, and the public to provide the best care possible for people nearing the end of life.

Populations around the world are ageing and more people are living with the effects of serious chronic illness towards the end of life. This publication provides examples of better palliative care practices, from or relevant to the WHO European Region, that range from a whole health system perspective down to individual examples of better education or support in the community and elsewhere. While some examples remain to be fully evaluated, they will nevertheless help policy-makers, decision-makers, planners and multidisciplinary professionals to plan and support the most appropriate and effective services for the care and quality of life of older people.

Full of practice-oriented tips, questions for further study, select online resources, and professional "profiles" in such diverse arenas as the emergency room, home care, case management, and hospice.