As in most other parts of the United States, many Delaware patients do not get the end-of-life treatment that they want. New studies, including one supported by the National Institute of Nursing Research, confirm that the MOLST paradigm is an effective solution to this problem. MOLST (Medical Order for Life Sustaining Treatment) improves the quality of care that people receive at the end of life through assuring the effective communication of patient wishes. MOLST has already been adopted in more than twenty states, including Pennsylvania and New York; and legislation is now pending in New Jersey. Recently, a task force has been working on bringing MOLST to Delaware. This article describes the benefits and challenges of this implementation.