I am committed to optimizing the quality of life for older adults in life’s final chapter through improved decision-making and communication about treatment preferences. A primary focus of my research has been on use of the Physician Orders for Life-Sustaining Treatment (POLST) Program to communicate patient treatment preferences as actionable medical orders. This tool helps ensure that patient preferences are known and communicated to improve continuity of care. Findings from my research have been widely disseminated and used in several states to support the development of programs based on the POLST model. In 2010, I co-founded and later co-chaired the Indiana Patient Preferences Coalition, a coalition of individuals and organizational representatives from across Indiana in law, medicine, nursing, senior care, and ethics. Our coalition led the drive to create the Indiana POST (Physician Orders for Scope of Treatment), (our version of POLST) through the Indiana POST Act (IC-16-36-6). I now provide education and facilitation skills training about POST to health care providers around the state. I also serve as the Palliative Care Core lead on a Centers for Medicare and Medicaid Services innovations grant to reduce avoidable hospitalizations and improve the quality of care in 19 Indianapolis-area nursing facilities. One key focus of OPTIMISTIC is to improve advance care planning through implementation of the new Indiana POST and enhanced symptom management. Additional work includes a collaboration with colleagues at IU Health that has resulted in the launch of the Encompass Initiative, designed to improve primary palliative care throughout the academic health system. Future plans include research on the quality of POST decisions and collaboration with area health care organizations to support the implementation of evidence-based best practices to improve palliative and end-of-life care throughout the community.