Caring at the End of Our Lives

Abstract

Growing up in West Virginia, I would hear older folks say, “Mr. Jones is failing now.” They meant that he had entered the final phase of disease and was now too tired to fulfill his usual obligations or even to care for himself and that he would soon take to his bed and die. This folk observation reflects the National Hospice Study's finding that measures of the quality of life of most persons dying of cancer declined substantially in their last few weeks.¹ Except for iatrogenic episodes, cancer usually means long periods of functional stability or slow decline, followed by . . .