It’s the only inevitable of life: it will end some day.

“End-of-life care” is a term used by the National Institutes of Health to define the support and medical care provided at the time when death is near, during the time surrounding death.

Such cases of end of life care don’t happen just in the moments before breathing finally ceases and your heart stops beating. Many old persons are often living with one or more chronic illnesses and need special caring for days, weeks, and sometimes even months.

People die differently. Some in great fear, others accept the inevitable peacefully. A dying person’s religious background can have much to do with the manner in which they face their finale time. As a devout Christian, for example, I have no fear of death. I will regret the end, but my faith tells me that because of my belief, I am confident I will have been given eternal life with my God.

The National Institutes of Health has established a new website for seniors. It provides comforting information about the most frequent issues that are customarily faced by those near death and for their loved ones. The end of life and how people die has changed a great deal in the past century.

Because of advances in public health, medicine, and health care, most Americans no longer die suddenly from injury or infection. Rather, we usually live longer and, more often than not, die after a period of chronic illness.

“Few of us are comfortable talking about death, our own or a loved one’s. While such reluctance is natural, it can leave people unprepared and uncertain of where to find answers, especially when they are needed most,” said Patricia A. Grady, Ph.D., director of the National Institute of Nursing Research (NINR), which developed the end-of-life topic for NIHSeniorHealth.

“As the lead NIH institute for research in this area, NINR supports science to assist individuals, families, and health-care professionals with end-of-life symptom management and decision making. Our goal with this module is to help people learn what to expect during the final stage of life so they can plan ahead….”

The End of Life module describes the physical, mental, and emotional needs of people nearing death, It advises ways in which their quality of life can be maximized, such as with hospice and home care. It also addresses those often complex practical concerns that can arise at the time of death, including financial issues, advance directives, caregiver support, and more. Other topics include:

• Addressing pain
• Types and places of end-of-life care
• Planning and paying for end-of-life care
• Handling health care issues
• When the end comes
• Coping with grief

The End of Life module joins an inclusive complex of research-based health topics geared toward seniors, including exercise and physical activity, long-term care, safe use of medicines and management of diseases such as stroke, diabetes, osteoporosis and Alzheimer's disease.

A joint effort of the National Institute on Aging (NIA) and the National Library of Medicine, which are part of NIH, are both part of NiHSeniorHealth.

One of the ways that end of life is provided is by hospice care. It is defined by the Centers for Medicare and Medicaid Services (CMS) as a program of care for a dying person whose doctor certifies has less than six months to live. The treatment under hospice is care, not cure.

There is palliative care, too. This is not hospice. It occurs when a person doesn’t have to be dying but an elderly person is living with one or more chronic illnesses.

The simplest, but not necessarily the easiest, way is deal with matters about end-of-life care is before an illness. Discussing your thoughts, values, and desires will help the people who are close to you to know what end-of-life care you prefer, or care where you, in effect, abandon your wants. You could discuss your illnesses or feelings about using life-prolonging measures or where you would like to be cared for.

Some people bring this up at a small family gathering. Others may find that telling their family they have made a will (or updated an existing one) provides an opportunity to bring up this subject with other family members. Doctors should be told about these wishes, as well. As hard as it is to talk about your end-of-life wishes, knowing your preferences ahead of time can make decision-making easier for your family. You may also have some comfort knowing that your family knows what you want of these services at some point in the future.

If you’ve been diagnosed with a terminal illness, talk to your to doctor about your treatment options. For example, how you want to give your money and possessions to others on your death. Create a financial inventory to help your family manage your affairs once you have died. The inventory includes information about your financial accounts, location of important documents, and online account numbers and passwords.

Tait Trussell is an old guy and fourth-generation professional journalist who writes extensively about aging issues among a myriad of diverse topics.

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