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End-of-Life Care

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Chronic Illness Care

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Abstract

Most people now die from chronic diseases. Attitudes and practices toward care as people near the end of life have changed dramatically over the past decades. Public advocacy and interest in self-determination have led to laws and policies that allow patients to indicate their wishes regarding end-of-life care. The medical community has responded, and end-of-life care has matured and been professionalized with the emphasis on compassionate and timely care. Determining when it is time to shift from curative efforts to an approach that focuses on comfort and quality of life is often not clear, and palliative care has evolved to include symptom relief while patients are still receiving curative treatment, allowing for a gradual transition in the focus of care. New quality metrics set a standard of excellence in practicing end-of-life care. Financing of end-of-life care continues to evolve. Populations such as children, patients with dementia, or those without the cognitive ability to make decisions require special consideration. Future initiatives in end-of-life care will focus on workforce preparedness, alternative financing models, innovations in electronic medical records, and support for the health-care workforce who serve the growing population of people who die from chronic diseases.

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Authors and Affiliations

  1. Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Margaret R. Helton

  2. Leiden University Medical Center, Public Health and Primary Care, Leiden, The Netherlands

    Jenny T. van der Steen

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Correspondence to Margaret R. Helton .

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  1. Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA

    Timothy P. Daaleman

  2. Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA

    Margaret R. Helton

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Helton, M.R., van der Steen, J.T. (2018). End-of-Life Care. In: Daaleman, T., Helton, M. (eds) Chronic Illness Care. Springer, Cham. https://doi.org/10.1007/978-3-319-71812-5_23

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