Nearly three-quarters of patients in Oregon hospitalized in the last month of life were discharged to home, compared with slightly fewer than two-thirds in Washington state and a little more than half — 54.2 percent — in the rest of the US.

More than 40 percent of patients in Oregon were enrolled in home hospice in 2013, compared with about 30 percent in Washington and fewer than 20 percent in the rest of the US, the analysis found.

Oregon, which enacted the nation’s first death-with-dignity law and led the way on implementing portable medical orders for treatment at the end of life, may be reaping the results of those and other efforts, said Tolle’s coauthor, Dr. Joan Teno, a professor of medicine, gerontology, and geriatrics at the University of Washingtonwith her, for company “and security,” he says. I ask Amanda if she wakes up excited, ready to ride, and she looks at me like, Um, no, I’m 24.

“Before this, I used to sleep in all the time,” she says.

As Amanda wakes and warms up, Ricky gives her a draft (legal according to the rules set out by the Ultra Marathon Cycling Association [UMCA], which validates the Highest Annual Mileage Record).

A high school track star in his home state of North Carolina, Ricky was an avid runner until Achilles problems turned him onto cycling. Amanda first began riding alongside her dad as a teenager, and found success as a racer, placing sixth in the time trial at the junior national championships in 2010, and later enrolling at Fort