Care at the End of Life

Overview

What decisions do you need to make about care at the end of life?

You will face many hard decisions as you near the end of life. Those decisions will include what kind of care you'd like to receive, where you'd like to receive care, and who will make decisions about your care should you not be able to make decisions yourself.

No one knows when his or her time may come. So it’s a good idea to spend some time planning what you want at the end of life. To be prepared:

• Decide what kind of health care you want or don't want. For example, you can decide whether you want CPR if your heart or breathing stops.
• Let others know what you've decided. Consider writing an advance directive that includes a living will and a medical power of attorney (also called a durable power of attorney). A living will is a legal document that expresses your wishes for medical care if you are not able to speak or make decisions for yourself. A medical power of attorney lets you to choose a health care agent. Your health care agent will have the legal right to make treatment decisions for you, not only at the end of your life but anytime you are not able to speak for yourself.
• Decide whether you'd like to donate your organs.

Will you have to choose between palliative care and treatments that might cure you?

One thing to think about is what type of medical care you want. Some people ask their doctors to do everything possible to keep them alive. This is called curative treatment. Others choose palliative care, which does not try to cure your illness or keep you alive longer. It looks at ways to make you more comfortable. For example, palliative care may include giving you medicines to help with pain or with the side effects from treatment.

You can have both types of treatment. You can get palliative care to help keep you comfortable, and you can take medicines or other treatments that might cure you.

But a time may come when you decide one is more important. You may choose to stop curative treatment if it is very clear that your illness can't be cured. If you choose palliative care only, you will still see your doctor and get excellent care. And if your condition changes, you can start curative treatment again.

Where would you like to be treated?

Another thing to think about is where you'd like to receive care. Some people check into a hospital. Others choose to be cared for at home or in a nursing home.

If you have only a few months left, you may choose to receive care through hospice. Hospice services are provided by a team of people that includes doctors, nurses, and volunteers. The team gives palliative care and emotional and spiritual support to people near the end of life and to their families. It also offers practical support like running errands or fixing meals. You can get hospice care in your home or in a hospice center, hospital, or nursing home.

What do you and your doctor need to know?

If you find out that you have a life-threatening disease or condition, talk with your doctor about the kind of medical care you'd like to receive. Ask a lot of questions about your illness and the treatments that are available. It can be helpful to have a friend or family member go to your appointments with you.

When you have decided whether you want palliative care or curative treatment or both, tell your doctor. Also, share your advance directive with your doctor.

How do you talk with your loved ones about your end-of-life choices?

It can be hard to talk with your loved ones about death, but it is important to discuss your choices while you can speak for yourself. Planning ahead will help you and your loved ones make hard decisions when the time comes.

Even though it might be awkward or uncomfortable, look for chances to talk about your end-of-life choices. For example, you could bring up the subject while you are making out your will. Or you could talk with loved ones after a visit to the doctor. Family gatherings are another place to make time to discuss your plans with loved ones.

Whatever you decide and whenever you decide to talk with loved ones, be sure to put your wishes in writing. You can always change your mind if your condition or your wishes change.

	Go to top of page	Go to next section
Author:	Bets Davis, MFA	Last Updated: July 14, 2008
Medical Review:	Anne C. Poinier, MD - Internal Medicine Shelly R. Garone, MD - Palliative Care
© 1995-2009 Healthwise, Incorporated. Healthwise, Healthwise for every health decision, and the Healthwise logo are trademarks of Healthwise, Incorporated. This information does not replace the advice of a doctor. Healthwise disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Terms of Use. How this information was developed to help you make better health decisions.