Living Well at the End of Life: Adapting Health Care to Serious Chronic Illness in Old Age

Most older Americans now face chronic illness and disability in the final years of life. These final years can prove painful and difficult for sick and disabled elderly people, who may have difficulty finding care to meet their needs. This period is often stressful and expensive for families. As currently configured, health care and community services simply are not organized to meet the needs of the large and growing number of people facing a long period of progressive illness and disability before death. This white paper synthesizes a growing body of research on the issue of chronic illness in the last phase of life. It describes the demographic and cost components of the problem, examines gaps in the current health care system, explores some reform measures that are addressing urgent needs, and outlines a vision for adapting the health care system to confront the new reality. This work has relied