MUSC's Center for the Study of Aging and the Program in Bioethics received a 1-year grant of $163,000 for an innovative end-of-life care program. University clinicians and community leaders will explore how Charleston's African-Americans approach death, and what types of care they prefer as they near the end of life. MUSC is one of 21 grantees selected by The Robert Wood Johnson Foundation from a pool of 678 applicants.

Through its new grant program, Promoting Excellence in End-of-Life Care, the foundation will award $9.1 million to fund programs that broaden access to comprehensive palliative care across a full range of clinical settings for terminally ill patients. Palliative care is an approach emphasizing physical comfort as well as emotional, social and spiritual well-being.

Promoting Excellence aims to foster long-term changes in health care institutions that will improve care for dying patients and their families. The program is a response to research showing that too many Americans die alone and in pain while receiving aggressive medical treatment not justified by its likely benefit.

MUSC will collaborate with Charleston's Enterprise Community, comprising 18 of Charleston's inner-city neighborhood associations and its community and religious leaders. Preferences related to palliative and end-of-life care, including hospice services, will be determined.

Local hospice programs provide palliative care, but most members of Charleston's African-American community do not choose this type of care as they or their loved ones near life's end. Instead, these residents often die in the hospital, frequently separated from family and friends.

This study, led by Jerome E. Kurent, M.D., will build on national surveys of preferences for end-of-life care among diverse cultures in America, as well as on previous studies of values, ethnic traditions and beliefs within the African-American community. This initiative represents a partnership involving The Robert Wood Johnson Foundation, MUSC and Charleston's Enterprise Community.

“In today's world people often know as long as several years in advance which chronic disease will cause their death, and this makes it even more urgent for palliative care to be widely available, to help people cope with the demands of such disease,” said Ira Byock, M.D., a preeminent hospice physician at the University of Montana and the former president of the American Academy of Hospice and Palliative Medicine, is the director of the Promoting Excellence Program.

“These projects have fresh ideas on how to make the fundamental changes we need in the structure, organization and priorities of the health care system in order to promote high-quality end-of-life care. Their work, we hope, will make changes that are long-lasting and spread to other institutions. In the long run we hope they improve the quality of life for a great many dying patients and their families,” said Byock.

The Robert Wood Johnson Foundation, based in Princeton, N.J., is the nation's largest philanthropy devoted exclusively to health and health care. It became a national institution in 1972 with receipt of a bequest from the industrialist whose name it bears, and has since made more than $2 billion in grants.

The foundation concentrates its grantmaking in three areas: to assure that all Americans have access to basic health care at reasonable cost; to improve the way services are organized and provided to people with chronic health conditions; and to reduce the personal, social and economic harm by substance abuse—tobacco, alcohol and illicit drugs.