Author Affiliation: Center to Improve Care of the Dying, RAND, Arlington, Va.
Until the last few generations, most people died quickly, following
an infection or an injury, or soon after the initial symptoms of an advanced
and untreatable condition like cancer, diabetes, or heart disease. After higher
mortality in infancy, deaths were arrayed evenly across the life span. In
developed countries, the scourges of a century ago have long been tamed. Modern
living conditions and health care have ensured that most will die slowly,
and mostly in old age. Seventy-eight percent of people in the United States
live past their 65th birthday, and more than three quarters of them will contend
with cancer, stroke, heart disease, obstructive lung disease, or dementia
during their last year of life.1
Lynn J. Learning to Care for People With Chronic Illness Facing the End of Life. JAMA. 2000;284(19):2508–2511. doi:10.1001/jama.284.19.2508
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