“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.”
Purpose: The report aims to address challenges in end-of-life care in the U.S. and improve the quality of care provided to individuals approaching the end of life.
Focus on Individual Preferences: Emphasizes the importance of person-centered care, respecting the unique values, goals, and beliefs of patients with life-limiting illnesses.
Communication Improvement: Recommends enhancing communication between healthcare providers and patients to ensure a clear understanding of treatment options and preferences.
Advance Care Planning: Advocates for the widespread adoption of advance care planning to document and convey individuals’ treatment preferences, enabling better alignment with patient wishes.
Professional Training: Highlights the necessity for healthcare professionals to receive adequate training in end-of-life care to provide comprehensive and empathetic support to patients and their families.
Community and Cultural Engagement: Stresses the significance of community and cultural engagement in creating a supportive environment for those at the end of life, recognizing the diversity of preferences and needs.
Systemic Transformation: Calls for a systemic transformation in the approach to end-of-life care, involving collaboration among policymakers, healthcare providers, and communities to ensure a holistic and patient-centric approach.
Committee on Approaching Death: Addressing Key End of Life Issues; Institute of Medicine. Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life. Washington (DC): National Academies Press (US); 2015 Mar 19. Available from: https://www.ncbi.nlm.nih.gov/books/NBK285681/ doi: 10.17226/18748