Health Resources:

For the Caregiver Caring for an ill, aging, or disabled person can be a rewarding experience. Depending on the level of care required, however, it can also become an overwhelming responsibility.

Making choices regarding care at the end of a persons life can be very difficult. It is not always easy to know what treatments should and should not be used. There are many confusing terms to understand.

One of the best ways to ensure that your wishes are carried out is to complete an advanced directive* (or living will).  However, these documents do little to ensure that your wishes will be followed if you have not spoken with your family. Sit down with your family and make sure that they are aware of your wishes and that they will respect them in the event that you are ill and unable to make choices for yourself.

Another option is to appoint a health care proxy. This person may be named in your advanced directive. He or she is in charge of making decisions for you in the event that you are not able to do so.

End of life decisions take on another level of complication when a person is admitted into the hospital. Even if you or your loved one has an advanced directive, it is essential that you bring a copy and discuss the issue in detail with your doctor and nurse.  This is because in the hospital setting we follow a Do Not Resuscitate (DNR) order in order to determine how to treat patients if a critical situation arises.

It is important to understand that a DNR order does not mean that a patient will not receive treatment while in the hospital.  It simply means that no extraordinary measures will be used in the event that a person stops breathing or their heart stops beating. These measures include things such as a breathing machine, chest compressions, or lifesaving drugs.

Another end-of-life issue that may be encountered in the ICU setting is the withdrawal of care or treatment. This is an issue that may arise in the event that it has been demonstrated that further treatment has little or no chance of resulting in recovery. The withdrawal of care is a very personal decision and it is specific to each situation. This decision should be made after meeting with the medical staff.

End-of-life decisions can become very complicated and require great thought. Choices are individual. Unfortunately, there is no one answer that is right for everyone. 

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