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Introduction to Death and Dying

By Elizabeth L. Cobbs, MD, Professor, Medicine, Geriatrics and Palliative Care;Chief, Geriatrics, Extended Care and Palliative Care, George Washington University;Washington DC Veterans Administration Medical Center ; Karen Blackstone, MD, Assistant Professor, Medicine, Geriatrics and Palliative Care;Director, Palliative Care, George Washington University;Washington DC Veterans Administration Medical Center ; Joanne Lynn, MD, MA, MS, Director, Center for Elder Care and Advanced Illness, Altarum Institute

Death is an intrinsic part of life, and talking about the likely outcomes of illness, including death and dying, is an important part of health care. Doctors and patients vary in the language they use and in their comfort level regarding such discussions.

People also vary in their comfort level regarding the amount of information and involvement in decision making that they want. Seriously ill people and their loved ones should generally try to understand the likely future course of their illness as well as the options for living with their particular disabilities and family situation.

People should make any preferences about treatment and family support known. Such preferences are known as advance directives. People who do not talk with their families and health care providers about their preferences for care near the end of their life may receive treatments (such as chemotherapy or surgery) or end up living in situations (such as a hospital or nursing home) they would not have wanted.