In the distant past, many acutely ill persons were encouraged and expected to assume a passive sick role.32 Hospital stays then were longer than today's, nursing and nursing assistants provide the care during recovery, and expectations for self-care after discharge were relatively simple.33,34 An increasing number of persons are surviving acute illnesses and a greater number of people live with chronic illnesses subject to acute exacerbations.35,36 People are treated and rapidly discharged from hospitals.37,38 Expectations for at-home management of complex conditions and treatment regimens have become common. People and their families are taught how to manage chronic conditions. Some people and families successfully managed, but many did not.