It seems that those with chronic diseases or the terminally ill hold on until the holidays or until after the holidays and then they just decide "it's time". Hospitals and nursing homes are filled with the sick. Families are stressed about limited physician visits and staffing availability more because they don't realize this is the norm than because this is an unusual occurrence. Sometimes it does take a squeaky wheel to get the necessary attention. The newspaper obituary columns are filled with loved ones who have moved on and mortuaries busy with celebrations of life.

Read more: Facility Staff Seen as Barrier to Hospice Referrals

Death -- not space, as mentioned in repeats of the old television series Star Trek, is the final frontier. It's a frontier most of us don't want to think about yet alone discuss. Fear, whatever the fear, is a subject we're not comfortable discussing unless we're engrossed in reality television or watching scary movies that we know in our hearts and minds are not real.

Fear of death is epidemic. So much that researchers have dedicated time to research fear of death. An article published in the Chicago Tribune called Understanding Fear of Death, divides fear of death into four areas: 1) fear of pain, 2) fear of the unknown, 3) fear of non-existence, and 4) fear of eternal punishment. Years ago death was a public event, an experience shared by those in the communities where we were born and died. How many of you have seen old black and white photos of family members laid out in caskets in private homes for viewing? There was a time, not too many years ago when loved ones died at home, in their bedroom, surrounded and cared for by family.

Read more: Fear Arrives When Death Disappeared Into Hospitals

Health care reform is in the press and arguments about whether the government's idea of rationing "will kill grandma" has delivered a great deal of controversy. Studies of healthcare in England place a value on the last year of life at $45,000. If the care required by an individual exceeds this amount, whether or not they will receive additional care is questionable.

Let's be honest. Who wants to talk about dying? Presentations about death generally empty rooms and conference halls. This is really the crux of the issue. We're ignoring our own end of life care so the government wants to intervene because our indecision costs the medical system too much.

Read more: Taking End of Life Into Your Own hands

By Pamela D. Wilson, The Care Navigator, CSA, MS, BS/BA, CG

How many of us consider that many of the older adults we care for are in the last years of their life?  How many of us realize our ability to positively impact their life?  How do you envision the last years of your life?  I don't know many people who purposely say, "I want to be as miserable as possible the last couple of years before I die."  How many people want to end life alone, isolated, in poor health or without the companionship of others?  Not many, yet it happens.  One day all of us will take this journey, we can't avoid it.  In our daily work with older adults, how can we support those already on this journey?

Read more: Care at End of Life – The Story of John D. and the Angels