Changes in the State of Care at the End of Life

According to the Institute of Medicine (IOM), health care delivery for people nearing end of life has changed significantly in the past two decades. Factors like the increasing number of elderly Americans, structural barriers in access to care for certain populations and a fragmented health care system present challenges to providing quality care near end of life. However, opportunities exist to improve this care, including a better understanding of ways to improve individuals’ participation in advance care planning and shared decision making, provisions of the Patient Protection and Affordable Care Act (ACA) and efforts to develop quality measures to enable accountability. In light of these developments, IOM published a comprehensive report on the current state of care for people of all ages who may be approaching death. For more info, please go to

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