Missoula Demonstration Project

To research the experience of dying and the determinants of quality at life's end.
To demonstrate that a community-based approach of excellent physical, psychosocial and spiritual care improves the quality of life for dying persons and their families.

Life's End Institute: Missoula Demonstration Project, Inc. was established in March 1996 as a fifteen-year effort to research the experience of dying persons and their families and to demonstrate that a community-based approach to excellent medical care and psychosocial support can consistently improve the quality of life among those who are dying and their families. The most basic assumption on which MDP operates is that prevailing attitudes about the end of life poorly serve patients, families of patients and care providers. Society as a whole suffers from the pervasive denial of death and from the lack of attention to the end of life. For many, attending to the end of life is not even a consideration.

MDP focuses on a small western city, Missoula, Montana, as a proving ground for a new way of thinking. MDP does not advance any specific vision for a "good death" or any agenda regarding the "right way" to die or to grieve. MDP exists instead to explore how we die, how we care for one another as we die and how we mourn, and to foster avenues for improvement.

We have begun with research, a high definition "snapshot" called the Community Profile. The questions we ask are as follows: What characterizes end-of-life experiences in our town? How do those who are involved, namely, dying patients, caregivers, clinicians and families, characterize their experiences? What is needed to improve these experiences? In doing so we have created a platform for research: state-of-the-art research tools, a research infrastructure and a database upon which to build our future endeavors.

As the research progresses, MDP hopes to demonstrate that improved care at the end of life and enhanced personal experience for individuals and families can be achieved through discussion of individual and community goals. MDP fosters that discussion among hundreds of individuals who serve on our local task forces, who agree to be objects of our research and who participate in MDP programs. Our method is to provide pertinent data from the research to the community as a catalyst for discussion and an avenue for change.

So that communities nationwide can learn from us, we are re-evaluating and reporting on each step of the way. Our goal is that in communities everywhere, individuals will have self-determined life closures; people will experience safe, comfortable dying; and healthy grieving will become a part of fuller living among us all.