Statement of Task
The IOM will conduct a consensus study that will produce a comprehensive report on the current state of health care for persons of all ages with a serious illness or medical condition who are likely approaching death and who require coordinated care, appropriate personal communication (or communication with parents or guardians for children), and individual and family support. The committee will assess the delivery of health care, social, and other supports to both the person approaching death and the family; person-family-provider communication of values, preferences, and beliefs; advance care planning; health care costs, financing, and reimbursement; and education of health professionals, patients, families, employers, and the public at large. The study will also explore approaches to advance the field. Specifically, the committee will:
- Review progress since the 1997 IOM report Approaching Death: Improving Care at the End of Life and the 2003 IOM report, When Children Die: Improving Palliative and End-of-Life Care for Children and their Families. The committee will assess major subsequent events and recommendations that have been implemented as well as those that were not implemented along with remaining challenges and opportunities.
- Evaluate strategies to integrate the care of those with serious illness or medical condition who are likely approaching death into a person- and family-centered, team-based framework. Demographic shifts, cultural changes, fiscal realities, and the needs of vulnerable populations will be considered as will advances in technology that affect the provision of care in different settings, most notably in the home. Families are a vital component of the healthcare team, and the financial and other ramifications for families and society will be considered.
- Develop recommendations for changes in policy, financing mechanisms and payment practices, workforce development, research and measurement, and clinical and supportive care. These recommendations will align care with individual and family values, preferences, and beliefs and promote high-quality, cost-effective care for persons with serious illness or medical condition who are likely approaching death.
- Develop a dissemination and communication strategy to promote public engagement, understanding, and action. This strategy will need to consider the fears and anxieties surrounding care for patients who are likely approaching death as well as functional dependency, aging and death, and cultural diversity in values, preferences and beliefs.