1:00 AM The approach wins praise and makes sense, but the U.S. health care system seems to work against it.

By LISA M. KRIEGER San Jose Mercury News

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Karen Gossage, a palliative care nurse, listens to the lungs of Marilyn Cronin, 58, of Soquel, Californa, who suffers from emphysema and liver failure, at her home this month.

Dai Sugano/San Jose Mercury News/MCT

WHAT IS PALLIATIVE CARE?

Palliative care -- from the Latin "palliare," which means "to cloak" -- grew out of the hospice movement of the 1970s.

It is care that helps patients with life-limiting illness in their final years. Its managers guide patients through difficult choices in planning for care and treatment and managing symptoms and spiritual, social and psychological issues.

Palliative care sharply contrasts in cost and patient experience with the prevalent end-of-life care in hospitals. Many studies confirm the high costs of physically and emotionally draining treatment for failing elderly people.

A study of the deaths of 5,158 elderly by UC San Francisco's Dr. Alexander Smith found that more than half had gone to the ER in the last month of their lives. Two-thirds went in their final six months. (Health Affairs, June 2012)

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Palliative care: A softer touch eases last years of life