Vincent Mor, professor of health services, policy and practice, testified June 13, 2012, before the U.S. Senate Special Committee on Aging, telling the legislators about progress and problems with the state of palliative medicine and end of life care in the nation. Brown research shows that nearly one in five patients with dementia experienced a burdensome transition in 2007, such as multiple moves among health care facilities at the end of life, and that the rates of such transitions varied widely among the states. “Financial incentives in the current fee-for-service system are aligned to promote the provision of more treatments and services and not health care based on informed patient preferences,” Mor told the senators. “Honest and complete communication about patients’ and families’ goals of care too often occurs too late." Mor recommended ideas to make care more accountable and to deliver care that honors family wishes.