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Dying in America. Improving quality and honoring preferences near the end of life. Consensus report

A substantial body of evidence shows that broad improvements to end-of-life care are within reach. In Dying in America, a consensus report from the Institute of Medicine (IOM), a committee of experts finds that improving the quality and availability of medical and social services for patients and their families could not only enhance quality of life through the end of life, but may also contribute to a more sustainable care system.

The IOM committee believes a person-centered, family-oriented approach that honors individual preferences and promotes quality of life through the end of life should be a national priority. Dying in America provides a comprehensive assessment of the knowledge gaps, structural problems, and financial disincentives that hamper delivery of optimal care and makes cross-sectoral recommen­dations to achieve compassionate, affordable, sus­tainable, and effective care for all Americans.

A number of factors make the IOM study particularly timely, including the rapidly increasing number of older Americans with some combination of frailty, physical and cognitive disabilities, chronic illness, and functional limi­tations. The U.S. population also is quickly becoming more culturally diverse, heightening the need for responsive, patient-centered care.


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