Care at the End of Life - Important Decisions
Choosing the care you want continued...
When you are diagnosed
with a life-threatening illness, it can be difficult to know how long you can expect to live. Talk with your doctor and your loved ones about when to start hospice. Many people do not start hospice until the last few weeks of life. Starting hospice sooner may help you and your family. For more information on this kind of care, see the topic Hospice Care.
Several factors may
impact your decision about the kind of care you want, including:
- Your illness. If you are diagnosed with a
serious illness, curative treatment options may be available. Certain diseases,
such as skin cancer, testicular cancer, and cervical cancer, are often cured
with appropriate medical treatment. Other serious illnesses, such as diabetes
and AIDS, cannot be cured but can be managed successfully for many years. And
some illnesses are more aggressive and life-limiting.
treatment options. Many medical treatment options offer the chance of curing a
disease with little effect on the quality of your life. Other treatments may
prolong your life but may be associated with side effects that drastically
decrease the quality of your life.
- Your age and other health
conditions. Older people with multiple health problems may be more likely than
healthier younger people to choose care that focuses on keeping them
comfortable rather than keeping them alive as long as possible.
For more information on making the decision to stop
curative treatments, see:
- Should I Stop Treatment That Prolongs My Life?
Talking to your doctor
When you are diagnosed with
a terminal disease or condition, it is important to communicate your
preferences and concerns clearly with your doctor. Likewise, you should expect
your doctor to communicate openly and sensitively with you and your loved ones.
Your doctor can provide information, answer questions, and advise you. But the
decisions are yours.
To get the most out of an appointment with your doctor:
- Listen carefully to what your doctor says. Make sure you understand what you are told about any diagnosis or treatment.
- Ask questions. If you don't understand something your doctor says, ask for it to be repeated in a different way.
- Be honest. If your values, beliefs, fears, or concerns may interfere with a treatment that is suggested, talk with your doctor about it. Other treatment options may be available.
- Ask for instructions. Before leaving your doctor's office, make sure you know what you are supposed to do to care for yourself. Ask for written information or instructions.
Important questions to ask your doctor include:
- What is my diagnosis?
- What are my
treatment options? What are the side effects of these
- What do you think will happen if I choose not to treat
- How long do you think I have to live?
- Will you tell me when you think I am ready for hospice?
soon do I need to make a decision about which treatment to use (or to not
- How will my illness and care affect my loved ones?
Prepare for your appointments
by writing down your questions and concerns and taking this paper to your
appointment. This will help you remember to address the important issues.
As your illness progresses, you may become too ill to continue seeing
your doctor at a clinic or to talk on the telephone. If you wish to be at home
as you die, it is helpful to designate only one family member or friend to
communicate with your doctor. Choosing one reliable person to relay messages
will help avoid the confusion caused by several people trying to communicate
with your doctor.