Serious Illness Care

Reduce Suffering & Respect Choices at the End of Life

Learn more about how we're taking action
Larry Stupski

Co-Founder, Stupski Foundation

“My experience caring for my husband, Larry, at the end of his life showed me the great need to change how seriously ill patients and their loved ones experience the end of life.” - Joyce Stupski
You or your loved one

Living with a serious illness

You and your loved ones should receive the type of care you want, in the manner you want it, free from unnecessary suffering.

Everyone living with a serious illness should be able to live their highest quality of life for as long as possible. The Bay Area is home to some of the best hospitals and clinicians in the world. Yet, patients with serious illness report alarming levels of physical, emotional, and spiritual suffering. One in 4 patients nationwide experienced unmet needs for pain, half suffered from a lack of emotional support, and almost 2 in 3 had spiritual or religious concerns. Each year, thousands of people in San Francisco and Alameda Counties are diagnosed with a serious illness and learn they are likely within the last year of their life. By 2029, we pledge to ensure these patients receive care that reduces unnecessary suffering and respects their wishes.

To reach our goal,

the Stupski Foundation will invest in the following initial strategies in the Bay Area:


Build Comprehensive Serious Illness Programs in Local Health Systems

When confronted with a serious illness diagnosis, patients land in the complicated, disconnected maze of the medical system, often with little knowledge about how to obtain the care they want. To improve patients’ end-of-life experience, we are working with hospital systems and medical groups across San Francisco and Alameda Counties to create comprehensive serious illness care programs. These programs have four elements:

Provide palliative care in all settings, including inpatient, outpatient, and the home.

Palliative care is a medical specialty that gives patients relief from the symptoms and stress of a serious illness and improves quality of life for the patient and their loved ones. We will work with health systems to ensure palliative care is available everywhere patients receive their care.

Capture and honor patients’ care preferences through multifaceted advance care planning.

To provide patients the care they truly want, patients and physicians must discuss options, clearly document patients’ wishes, and share that information with all members of the care team. We will work with our partners to educate patients, train physicians and health care workers, and integrate patient preferences into electronic medical records to ensure patients receive the care they want.

Provide family caregiver support.

Studies show that when family caregivers receive emotional or practical training, counseling, case management, and/or respite, they report lower rates of depression and provide better care to patients. The studies also show that caregiver support can lead to a reduction in hospital readmissions and emergency room visits for those being cared for. We will work with health care providers to integrate family caregiver support alongside patient care.

Connect patients to the social services they need.

Living with a serious illness requires more than medical care alone. We will work with our partners to connect people with a serious illness to social services that can help with activities such as food delivery, transportation to appointments, and adapting their homes to be more comfortable.

Reach all patients

Support Community Organizations to Engage Hard-to-Reach Populations

Many patients fall through the cracks of the health system because they do not know how to access services, face language, racial, and cultural barriers, or distrust the medical system. We will fund community-based programs to connect with patients in these communities so that everyone has the opportunity to receive the care they need.

Build shared infrastructure

Develop Capacity and Shared Infrastructure Outside Health Systems

Health systems do not need to reinvent these programs from scratch. There are a variety of evidence-based programs that can help health systems train clinicians to provide generalist palliative care, communicate with patients, or integrate advance care planning into their workflows. We seek to ensure that those programs have the capacity needed to meet local Bay Area demand.

We also recognize the need to coordinate some shared services across health systems, as exemplified by the movement toward electronic POLST (Provider Orders for Life-Sustaining Treatment) registries. We are monitoring what shared infrastructure the two counties may need. 

In Hawai‘i, Stupski invests in organizations aligned with our focus areas. We are developing specific Hawai‘i strategies and investments in collaboration with the Hawaiʻi Community Foundation and our other partners across the islands over the next year. We look forward to sharing those strategies soon.