Thus, it is important to help patients and their families articulate their goals of care and preferences near the EOL. In addition, death in a hospital has been associated with poorer quality of life and increased risk of psychiatric illness among bereaved caregivers.

Patient recall of EOL discussions, spiritual care, or early palliative care, however, are associated with less-aggressive EOL treatment and/or increased utilization of hospice. Patient and family preferences may contribute to the observed patterns of care at the EOL. Significant regional variations in the descriptors of end-of-life (EOL) care remain unexplained. However, the average length of stay in hospice was only 9.1 days, and 11% of patients were enrolled in the last 3 days of life. Conversely, about 61% of patients who died used hospice service.

Approximately 6% of patients nationwide received chemotherapy in the last month of life. In addition, 29% of patients were admitted to an intensive care unit in the last month of life. Across the United States, 25% of patients died in a hospital, with 62% hospitalized at least once in the last month of life. A report of the Dartmouth Atlas Project analyzed Medicare data from 2007 to 2010 for cancer patients older than 65 years who died within 1 year of diagnosis. People with cancer die under various circumstances. Despite progress in developing treatments that have improved life expectancies for patients with advanced-stage cancer, the American Cancer Society estimates that 609,820 Americans will die of cancer in 2023.

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