Of the 5 million Americans with failing hearts, about half of them will die within five years of getting diagnosed. Given the odds, it seems that people with heart failure should start thinking about how they want to die. But doctors don't routinely talk to those patients about end-of-life planning. When researchers asked 50 doctors and 45 nurse practitioners and physician assistants how often they discuss preparing for death with their heart failure patients. A third of the providers said they lacked confidence in talking about end-of-life care. Only 12 percent said they have routine yearly discussions about the end of life.