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Today’s doctors are trained to keep patients alive, but not always to prepare them for death. From developing a care plan to delivering the news to supporting their patients’ medical, emotional and spiritual needs, most doctors are uncomfortable starting the conversations required to develop the most appropriate end-of-life care plans.

As Baby Boomers retire and age, we have an older generation that has grown up expecting continuing gains to their longevity. But longevity doesn’t mean everyone who lives longer lives in good health. In fact, according to the National Centers for Disease Control and Prevention, about 60 percent of adult Americans have a chronic disease, and 40 percent have more than one1. Our medical community needs to ensure that the sickest and most vulnerable in this generation will receive comprehensive, high-quality, person- and family-centered care that honors their dignity and choices and is consistent with their goals and values.

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Eighty percent. That’s how many Americans would like to die at home. But despite the fact that 70 percent of Americans die from chronic illnesses1, giving them time to anticipate their deaths, over 50 percent still die in hospitals or nursing homes.2  Of the Medicare patients who died in 2016, only 48% received hospice services at the time of death3, even though every patient was eligible for six months of hospice care.

Prior to 1950, the majority of Americans did die at home. At that time, many chronic and advanced illnesses were untreatable, and all physicians could offer was palliative care. Over the next few decades, innovations in medicine enabled doctors to prolong life with medical and surgical interventions and for hospitals to treat patients with ventilators and IV anesthesia. As seriously ill patients lived longer, medical institutions recognized advanced illness management as an effective way to maximize their profits.

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