This book is a study of the current state of health care for persons of all ages with a serious illness or medical condition who are likely approaching death. The book provides a detailed description of important aspects of the current U.S. health care system as they affect Americans nearing the end of life.

The book evaluates strategies to integrate care into a person- and family-centered, team-based framework. According to this report, the current health care system of rendering more intensive services than are necessary and the lack of coordination among programs increases risks to patients and creates avoidable burdens on them and their families. This report makes recommendations to create a system that coordinates caregiving and supports and respects the choices of patients and their families.

Contents
Foreword
Acknowledgments
Acronyms
Summary
Introduction
2 The Delivery of Person-Centered, Family-Oriented End-of-Life Care
3 Clinician-Patient Communication and Advance Care Planning
4 Professional Education and Development
5 Policies and Payment Systems to Support High-Quality End-of-Life Care
6 Public Education and Engagement
Glossary
REFERENCES
Appendix A: Data Sources and Methods
Appendix B: Recommendations of the Institute of Medicine's Reports Approaching Death (1997) and When Children Die (2003): Progress and

Significant Remaining Gaps
Appendix C: Summary of Written Public Testimony
Appendix D: Financing Care at the End of Life and the Implications of Potential Reforms
Appendix E: Epidemiology of Serious Illness and High Utilization of Health Care
Appendix F: Pediatric End-of-Life and Palliative Care: Epidemiology and Health Service Use
Appendix G: Committee Biographies

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