Although a growing body of research supports a link between effective communication and patient, family and physician satisfaction, doctors, including oncologists and other specialists who frequently care for terminal patients, do not routinely receive training in end-of-life conversations during medical school, residency training, or after they start to practice medicine.

There is an urgent need to improve end-of-life care for older people in the final stages of dementia, according to an international review published in the May issue of Journal of Clinical Nursing.

As a brain-damaged woman named Terri Schiavo lived her final days in 2005, her family's bitter feuding imparted a tragic lesson about the importance of specifying one's wishes for end-of-life medical treatment.