Here are some important facts about the current state of dying in America. The first and maybe most important one shouldn’t surprise anyone, although it often seems to:

We’re all going to die one day.

As certain as that reality is, we often don’t plan for it, and as a culture we resist talking about it. And yet, not thinking about it can mean the difference between a good death and a wrenchingly hard one.

That’s why the nonpartisan Reclaiming the End of Life Initiative is so important for New Hampshire and the nation. Developing compassionate, cost-effective strategies for caring for the frail elderly and ill of any age now is critical to ensuring that we all die well, not simply die. Here, at a glance, are some startling facts about dying.

2.4 million people die in America each year. By far, the majority are frail elders. [1]

20 percent of Americans die in hospital intensive care units, part of the 50 to 60 percent of Americans who die in hospitals. Another 25 to 35 percent die in nursing homes. [2]

Only 20 to 30 percent die at home, despite the fact that surveys have repeatedly shown that is where we want to be when we die. [3]

By 2030, the numbers of Americans 65 and older will more than double, going from roughly 35 million in 2000 to about 71.5 million. [4]

The number of Americans 85 or older is also projected to more than double during that time, from 4.2 million in 2000 to 9.6 million in 2030. [5]

New Hampshire is aging more rapidly than America’s population as a whole. The census bureau predicts a rise in residents 65 and older of 138 percent—compared to a national average of 104 percent—between 2000 and 2030. New Hampshire residents 65+ will total almost 25 percent of the state’s population by 2030. [6]

In 1990 the average ratio of caregivers per elderly person was 11 to 1. If current patterns continue, estimates are it will be 6 to 1 by 2030 and 4 to 1 by 2050. [7]

Nearly half of Americans who live to 65 will enter a nursing home before they die. [8]

Already, according to a Congressional study, more than 90 percent of nursing homes have too few workers to care for patients. [9]

By 2010, nearly half of all nurses will be over age 50, exacerbating what is already a national nursing crisis. [10]

REFERENCES

[1] CDC: Death Rates By Age Group

[2] Society of Critical Care Medicine, 2006

[3] A 1999 Harvard Public Opinion Poll found that 71 percent of Americans would prefer to die at home. A 2002 Harris Interactive Poll found that 86 percent of Americans believe that people who have a terminal illness would most like to receive end-of-life care at home.

[4] U.S. Bureau of the Census Interim Projections: Change in Total Population and Population 65 and Older, by State: 2000 to 2030

[5] U.S. Bureau of the Census: Interim Projections of the Population by Selected Age Groups for the United States and States: April 1, 2000 to July 1, 2030

[6] U.S. Bureau of the Census: Population Pyramid of New Hampshire

[7] International Longevity Center and the Schmieding Center for Senior Health and Education, 9/6/2006

[8] JAMA 2000 Nov. 15 2841(19)

[9] Ref. NY Times, “9 of 10 Nursing Homes in U.S. Lack Adequate Staff, a Government Study Finds,” Robert Pear, 2/18/2002

[10] HRSA Projections by Divisions of Nursing