Home care and hospice service delivery focus on a range of new ways of getting more services into the home-with a difference. Self-care and self-management, with the assistance of tools-not professional care-is becoming the order of the day.

For persons nearing the end of life and their caregivers, this responsibility may seem particularly burdensome. However, the trend may bring welcome respite for some patients as well as their caregivers.

You can learn more about trends in tool design and service development for patients at various points in the spectrum of care need, especially those nearing the end of life, by visiting the Last Acts Web site (http://www.lastacts.org), sponsored by the Robert Wood Johnson Foundation and viewing the "Tomorrow's Tools" section. The December, 1999 installment of "Tomorrow's Tools" is entitled "Machines that talk-and talk back!" A list of readings, a Public Forum, and related materials are provided to introduce visitors to what is termed a "sea change in technology's use in outpatient sites, where there can now be 'virtual caregivers' unlike any before." A new addition to "Tomorrow's Tools" is an Expert Forum in which clinicians, engineers, and inventors of innovative care technology will address the question: "What is the value of talking machines at the end of life?"

Questions can be addressed to the section's moderator. Audrey Kinsella, MA, MS, Research Director, Information for Tomorrow, via e-mail at [email protected] or by calling (301) 581-0090.