“People can change their life as many times as they wish,” he said. Having a goal is important, which is why he constantly learns new things.

Northwell Health’s community paramedics program published its results this summer in The Journal of the American Geriatrics Society, looking at outcomes for 1,602 ailing, homebound patients (median age: 83) over 16 months. When the community paramedics responded — most commonly for shortness of breath, neurological and psychiatric complaints, cardiac and blood pressure problems, or weakness — theywere able to evaluate and treat 78 percent of patients at home.

Out of nowhere, a patient I recently met in my clinic told me, “If my heart stops, doctor, just let me go.”
“Why?” I asked him.
Without hesitating, he replied, “Because there are worse states than death.”

Mr. Swensen, 62, runs the school’s $25.4 billion endowment, one of the largest in the country. Usually he is joined by his intellectual sparring partner, Dean Takahashi, his senior director. It amounts to an internship in the world of managing a university’s billions — and the young analysts have a front-row seat.

The founders of Silicon Valley’s technology companies, many of whom have amassed huge fortunes at a young age, tend to look at their philanthropic giving much as they do their companies: They study a problem, explore a number of ways to attack it and eventually invest heavily to scale up the ideas they think will be winners.

Religious institutions are still the single biggest recipients of overall charity donations, according to the 2015 survey by the Giving USA Foundation. About 32 percent — $119.3 billion — of a total of $373.25 billion Americans gave to charities went to churches, synagogues, mosques and temples.

Mention the name Paul Newman and many movie buffs will describe the charismatic actor with the piercing blue eyes who starred in films like “Cool Hand Luke,” “The Sting” and “Butch Cassidy and the Sundance Kid.” But many people will identify Mr. Newman as the philanthropic kingpin, whose Newman’s Own food brand has raised hundreds of millions of dollars for charity.

WESTPORT, Conn. — Newman’s Own was having trouble getting the word out about its philanthropy.
The brand has “All Profits to Charity” inscribed across every label on its popular salad dressings, tomato sauces and microwaveable popcorn — a pledge that has amounted to more than $485 million donated since 1982.

After a series of attacks against immigrants and minorities since Election Day, the financier George Soros says he will commit $10 million from his personal foundation to combat a rise in hate crimes that he linked to the “incendiary rhetoric” of President-electDonald J. Trump’s campaign.

It’s an uphill struggle, and it is one that is shared by any nonprofit shopping the market for 403(b)’s, the 401(k)-like retirement plan that nonprofits usually adopt.
For an organization that has no retirement plan but wants to add one, moreover, the diverted staff time and cost can affect whether, say, more clients learn to read.