Palliative in Practice-Ten years ago there were few palliative care teams in hospitals, but today more than 63 percent of hospitals with 50 beds or more provide palliative care. Systems and structures for quality care are improving. There are Joint Commission certification standards, National Consensus Project for Quality Palliative Care Domains of Care and Guidelines, and Preferred Practices for Quality Palliative Care from the National Quality Forum.

However, gaps remain in communication and consumer understanding of patient-centered care for those with serious chronic illness. Although 70 percent of people say they want to die at home surrounded by family, 70 percent die in nursing homes and hospitals, often in intensive care units. “Dying at home” doesn’t just mean where they want to die, but how: in comfort, among people who care about them, doing what matters for as long as possible.

A November 2012 Time Magazine cover story captured the growing American experience: “How To Die: What I Learned from the Last Days of My Mom and Dad.” Joe Klein’s article generated conversations on television talk shows, social media and in editorials about what kind of care people want for themselves and their loved ones.

In July 2013, NPR’s “Weekend Edition” radio host Scott Simon tweeted for a week from his mother’s bedside as she died. More than 1 million people followed him on Twitter as his gripping real-time story played out. The story went viral online and was covered on TV and in national and local media outlets including The Atlantic, which ran an article, “How Social Media is Changing the Way We Approach Death.”

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