ABSTRACT
This chapter examines medical, social, and cultural contexts of decision making for older persons living with serious illness or approaching the end of life. The history and goals of person-centered care are highlighted, and their implications for more humanistic, relational practice with older persons discussed. New York is used as an example of policy making and policy implementation at the state level. The case of a frail elderly nursing home resident who is negotiating hospice care transitions illustrates the challenges posed by the complexity of decision making for older persons, as well as their professional and family caregivers. Recommendations are made to strengthen the critical role of interdisciplinary ethics committees through the design of comprehensive ethics committee education.
