The proportion of Americans entering old age is rapidly increasing. By 2050, the number of citizens age 65 or older is expected to increase to 83.7 million, more than double the age group population in the 2010 census. The leading causes of death in people age 65 and greater are malignant neoplasm and chronic disease, often requiring rigorous long-term treatment and close medical care. As the older population grows, the cost of healthcare during the last years of life falls heavily on Medicare. The incidence of admissions to the intensive care unit during the last month of life has continued to increase over time. Unfortunately, many of these hospital visits entail aggressive life supporting measures that function only to prolong the dying process at a large financial cost.