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Means to a Better End

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By Nancy Volkers

Many Americans don't know about options for end-of-life care, or they don't think to ask for them. Now, "Means to a Better End," an RWJF-funded report, evaluates each state and the District of Columbia on the ability to provide care at the end of life.

Bottom line: No state does better than a mediocre job in providing for end-of-life care for its residents.

The report was generated by Last Acts, a national campaign to promote improvements in care and caring near the end of life. Last Acts is the nation's largest coalition dedicated to end-of-life care reform, with almost a thousand national and local partner organizations. The group's analysis used eight criteria that represent key elements involved in end-of-life care and gives each state 12 "grades" on those elements.

Good end-of-life care — often called palliative care — does not try to cure people of disease, but to do everything possible to make them comfortable and promote quality of life, however short. Palliative care relieves physical symptoms and provides emotional and spiritual support to patients and family members.

Last Acts, which was launched by RWJF in 1996, hopes that its report sparks a public discussion and stimulates efforts to improve access and quality. Medical advances have increased the average life expectancy in this country, and the percentage of older people is skyrocketing: Between 2000 and 2020, the number of people 65 and older will have increased by more than 50 percent. (Source: National Population Projections, U.S. Census Bureau).

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