Report card on palliative care.

Released November 18, 2002, Last Acts' state-by-state analysis, "Means to a Better End: A Report on Dying in America Today," sets out statistics of the availability and use of good end-of-life care. The report also calls for specific action steps to strengthen care for dying Americans. Access the full report online at www.lastacts.org. An interactive special report on Means to a Better End, including research findings, is available on The Robert Wood Johnson Foundation Web site, www.rwjf.org/special/betterend.

According to the report, America does only a mediocre job of caring for its most seriously ill and dying patients. The nation's first state-by-state "report card" on end-of-life care grades all 50 states and the District of Columbia from A to E on eight key elements of palliative care (with A being the best possible grade and E, the lowest): state advance directive laws; portion of deaths that occur at home; rate and duration of hospice use among the dying; access to hospital end of life care services; intensive care unit stays at the end of life; pain among nursing-home residents; state pain-management policies; and …