Chronic heart failure (CHF) and chronic obstructive pulmonary disease (COPD) have commonalities that make them ideal for early palliative care provided alongside disease-specific treatments. Quality of life is reduced in both illnesses because, despite disease-specific treatments, the same symptoms (e.g., shortness of breath, fatigue) often persist in CHF and COPD. Quality of life is also reduced because between 50-60% of people with either illness have clinically significant depressive symptoms. Finally, while CHF and COPD are leading causes of hospitalization and mortality, few people with either illness engage in advance care planning. Providing palliative care concomitantly with other medical care offers an important opportunity to improve quality of life and advance care planning for people with CHF or COPD. For other conditions such as lung cancer, when provided early, prior to the end of life, palliative care improves quality of life, depressive symptoms, and survival while reducing health care utilization. While palliative care has been well-studied in patients with advanced cancer, it has not been adequately studied in CHF or COPD. The goal of this proposal is to determine whether the benefits of early palliative care extend to CHF and COPD.