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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.
  • Your 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:

dplink.gif 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 treatments?
  • What do you think will happen if I choose not to treat my illness?
  • How long do you think I have to live?
  • Will you tell me when you think I am ready for hospice?
  • How soon do I need to make a decision about which treatment to use (or to not use)?
  • 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.

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WebMD Medical Reference from Healthwise

Last Updated: July 06, 2012
This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.
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