Advancements in medical care and technology during the 20th century have significantly increased life expectancy in the United States. While extending life is beneficial, it often compromises the quality of life and the experience of dying. Concerns have been raised by some disabled individuals that healthcare providers often prioritize quality of life to the extent that it may not reflect the patients' own wishes regarding life-prolonging treatments. Research indicates that many people receive more aggressive treatment at the end of life than they would prefer. These issues underscore the need for better end-of-life documentation in the U.S.. To improve advance care planning, primary care providers should proactively engage middle-aged patients in discussions about their end-of-life wishes and available options.